AIIMS panel for intestinal transplants in Delhi

Senior AIIMS officials said while the programme is still at a nascent stage, the facility will be provided to recipients at a much cheaper rate as compared to their private counterparts

Children with underdeveloped or damaged intestines will soon be able to get a transplant at India’s premier medical institute – All India Institute of Medical Sciences (AIIMS) – according to people aware of the matter.

The facility will initially be for children and will later be extended to adults. (PTI)

Senior AIIMS officials said while the programme is still at a nascent stage, the facility will be provided to recipients at a much cheaper rate as compared to their private counterparts.

The hospital has formed a 10-member committee to lay a roadmap and procure a license to conduct intestinal transplants, a first for the institute. The experts will also be the first from the institute to be trained in this procedure.

Dr V Seenu, head of the department of surgery at AIIMS, who is also the chairperson of the committee, said they are formulating a detailed proposal. He said that the programme will commence with paediatric transplants because the success rate of such surgeries among children is much higher compared to adults.

This will eventually be extended to adults as well, officials confirmed. Officials said that the hospital will be applying for a license with the National Organ and Tissue Transplant Organisation, an organisation set up by the Union health ministry to oversee organ donations and transplants across the country.

“Even though we have the expertise, we will introduce the programme in phases. We will start with transplants for children because many are born with underdeveloped intestines, meaning their intestines are either partially formed or not formed at all. In other cases, intestines are also damaged due to injuries,” Dr Seenu said.

Patients with damaged or underdeveloped intestines have to rely on parenteral nutrition, which requires feeding them intravenously. Currently, two such children under the age of 14 years are admitted to AIIMS.

In India, the first such successful transplant happened in 2013 at Medanta Medicity, where a small intestine was transplanted from a cadaver donor to a 30-year-old. The procedure cost ₹30 lakh.

Treating doctors said that a major vein of the recipient’s intestine was blocked, restricting blood supply and making almost all of his small intestine non-functional.

While intestinal transplants are only gaining ground in India, these surgeries have been successfully conducted in many countries abroad for some time now.

A study by Dr Vikram K Raghu, department of paediatric gastroenterology, hepatology, and nutrition at the UPMC Children’s Hospital of Pittsburgh, analysed data from the intestinal transplant registry (ITR), an international database for centers around the world to contribute to current knowledge about surgery outcomes.

The paper highlighted that between 1985 and 2017, 2,010 children received 2,080 intestines containing allografts. “Overall, one-year and five-year patient and graft survival rates were 72.7%/66.1% and 57.2/48.8%, respectively. One-year conditional survival was more strongly associated first-time transplant recipients and liver-inclusive grafts. Patient survival was more strongly associated with the elective status of transplantation,” the study said.

Doctors at AIIMS said that generally, a recipient requires 100-200cm of intestine from a cadaver donor. However, some hospitals in India have also successfully managed intestinal transplants from live donors. The biggest risk behind the failure of such transplants is the chance of high infection and jettisoning of the transplanted organ, which is why doctors wait for the patient’s recovery before declaring such transplants a success.