Himanshu Singh’s gangrenous small intestine didn’t allow him to eat anything normally, which led to him go from weighing 74kg to 37kg in three years. He could not digest his food normally, his body was not able to absorb nutrients and he could have remained permanently dependent on intravenous nutrition.
Dr AS Soin, chairperson of the Medanta Institute of Liver Transplantation and Regenerative Medicine, explained that patients with intestinal failures were considered for transplant only when total parenteral nutrition (TPN) had been tried for a while and it could not be tolerated further because of complications, and the remaining intestine could not adapt to recover its function.
“I would go for my TPN routine on Friday evenings and it would continue till Monday mornings. This ate away my social life,” said Himanshu, who continued to work till a few days before the transplant.
The intestinal transplant that cost the 30-year-old around Rs.30 lakh had only 60% chances of long-time survival. “Through TPN, he was getting barely a fourth of the nutrition his body needed. He became very weak and that’s when we decided to do this major surgery,” said Dr Ravi Mohanka, senior transplant surgeon at the hospital.
The challenge was to find an intestinal donor. The intestine in Himanshu belongs to a 20-year-old, who lost his life in a road accident.
“He was a healthy person with all organs intact. The blood group also matched," added Mohanka. The team was contacted by NGO, MOHAN Foundation, which has been coordinating organ donations and transplants in Delhi and South India for long.
After the successful transplantation, there was yet another concern. "After the transplant, we had to prevent any kind of infection or rejection, which is common in intestinal transplants. We conducted 500 blood tests in a month to detect any infection,” added Soin.
Rejection in intestinal transplants is the highest because intestines are the storehouse of immune cells, for which Himanshu will have to be on immune-suppression for the rest of his life.