Liver transplant on obese patient weighing over 150 kg in Mumbai

A 42-year-old morbidly obese patient weighing over 150 kg got a new lease of life following a complex liver transplant in Mumbai.

Ateam headed by Dr Gaurav Chaubal, Director of Liver, Pancreas, Intestine Transplant Program, and Hepato-Pancreato-Biliary Surgery at Global Hospitals, Mumbai successfully performed the operation.

The patient, Jitendra Belgaonkar, a businessman from Nashik was always on the heavier side and was diagnosed with fatty liver disease.

The patient was suffering from fatty liver disease which progressed to liver cirrhosis and was listed for a cadaveric liver transplant for more than a year. His clinical condition continued to deteriorate despite optimal medical management and he was advised to register himself for a deceased donor liver transplant.

His clinical condition worsened further and with no other option left in hand, the doctors at Global Hospital Mumbai meticulously planned the transplant surgery and saved the life of the patient by doing a living donor liver transplant.

During the pandemic, the patient noticed symptoms such as blisters (fluid-filled bubbles) on his body, lip bleeding, and leg swelling, and was rushed to the hospital. His investigation revealed a high creatinine level of 4 (mg/dL), and the fatty liver disease progressed to liver cirrhosis. Bloating, inability to empty the bowels, ascites (build-up of fluid in the abdomen) and other symptoms required recurrent hospital admissions to be treated.

As the fatty liver disease had progressed to Liver cirrhosis, Dr Sharad Deshmukh, Senior Gastroenterologist at Nashik, suggested a liver transplant and registered the patient on the cadaver donation list in Pune. Despite optimal medical management, his clinical condition worsened and he was admitted frequently to the hospital. After waiting for a year, his wife, seeing his condition, came forward to donate a part of her liver.

“The patient was referred to in a critical situation. His liver function was low due to end-stage liver disease. Due to excess weight, his case was unique as well as challenging. Living donor transplant is not recommended in obese patients (weighing over 100 kgs) as they require a bigger size of graft leading to an insufficient remnant for the donor. We prefer doing a dual lobe living donor surgery or a deceased donor liver transplant as the graft weight is acceptable. He was waiting on the deceased donor waiting list for almost a year and didn’t get an organ. Additionally apart from his wife, no one in his immediate family could donate a part of their liver due to medical conditions. Looking at his condition, a decision of performing a liver transplant was taken with the help of a modified technique,” said Dr Chaubal.

““Though my husband was obese, he was active and played basketball on a regular basis. It was a shock to us when we came to know about Fatty Liver Disease and jaundice. He was in pain and suffered a lot but he would do the daily chores on his own. His health deteriorated and he would just sleep the entire day without doing anything,” said Jayashree Belgaonkar, his wife who donated part of her liver.