A swap transplant happens when the first patient’s close family member donates their organs (kidney or part of the liver) to the second patient. In return, the second patient’s relatives donate their organs to the first patient, said a doctor.

In what appears to be a cornerstone for human empathy achieved purely by means of advancements in the field of medicine and healthcare, two women saved the lives of each other’s husbands by sharing a part of their liver and helping them undergo life-saving transplants; the two men suffered from end-stage liver disease. Also known as ‘swap liver’, the transplant happened at the Global Hospitals in Parel, Mumbai, and was led by a team of prominent doctors like Dr Gaurav Chaubal, director of liver, pancreas, intestine transplant program, and HPB surgery; Dr Samir Shah, director of liver disease, HPB surgery and transplant; and Dr Uday Sanglodkar, senior consultant hepatologist and clinical lead, liver and transplant ICU. The 10-hour simultaneous transplant procedures successfully saved the lives of both the patients.

The Patients

One of the patients was a 61-year-old man from Amravati, who suffered from diabetes, hypertension, hypothyroidism, interstitial lung disease. He also struggled with ascites buildup and hepatitis C that led to end-stage liver disease (liver failure). Ultimately he could not perform his daily activities. The other patient, a 41-year-old man, had a history of hepatitis B that caused his liver to fail. The two individuals had been waiting for a transplant for over a year.

The Transplant

According to Dr Chaubal, the patients’ wives were ‘eager’ to donate a part of their livers, but a thorough recipient and donor evaluation found that their blood types did not match with their partner’s, making them incompatible for the transplants.

‘Swap’ Transplant

It was then decided that the couple could opt for something known as a ‘swap’ transplant.

“A swap transplant happens when the first patient’s close family member donates their organs (kidney or part of the liver) to the second patient. In return, the second patient’s relatives donate their organs to the first patient. [Patient 1’s] wife donated a portion of her liver to [patient 2], while [patient 2’s] wife donated her liver to [patient 1]. The two transplants were carried out concurrently for 10 hours on two donors and two recipients. The recipients were discharged in 14 days; the donors in 7 days,” said Dr Chaubal.

Dr Sanglodkar, meanwhile, added that one patient was A blood group and the second was B blood group. They did not have a family member with the same blood group. “A swap transplant means a blood group that is not available in the family can be taken from the other family. Both the patients were critically-ill and required frequent hospitalisations,” he said.

Scarcity Of Eligible Donors

“There is always a scarcity of eligible donors in liver transplantation, causing mortality in patients with advanced liver disease. Swap transplantation is an excellent way to add to the donor pool and benefit more patients,” said Dr Ameet Mandot, HOD, clinical lead, adult hepatology and liver transplant at Global Hospitals.