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Does premier medical centre need a surgical healing touch?

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A team of surgeons and doctors from Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) in Lucknow and the Institute of Liver and Biliary Sciences (ILBS) in New Delhi performed a liver transplant on an 18-year-old girl on February 12, 2022.

The Centre for Hepatobiliary Diseases and Transplantation has failed to perform even one liver transplant per year. (For Representation)
The Centre for Hepatobiliary Diseases and Transplantation has failed to perform even one liver transplant per year. (For Representation)

But since then, not a single liver transplant has been carried out at SGPGIMS, despite it being one of the state’s premier medical institutes, according to people in the know of things. The last transplant before this was performed on a nine-year-old boy on January 24, 2019, they said.

The Centre for Hepatobiliary Diseases and Transplantation (CHBDT), a state-of-the-art 100-crore facility inaugurated by chief minister Yogi Adityanath on October 15, 2018, has failed to perform even one liver transplant per year. In fact, in the five years since its inception, only three liver transplants have been conducted at this facility—a far cry from the lofty expectations and promises that accompanied its launch.

Originally conceived to address the critical need for liver transplants in the region, the center was expected to offer a lifeline to numerous patients suffering from liver failure.

There are several reasons why the institute has struggled to establish a successful and regular liver transplant program, one of them is allegedly the skillset of the present surgeons at the institute, according to people familiar with the issue.

Experts suggest that approximately 6,000 liver patients in the state require transplants. As a result, many patients are forced to seek treatment at hospitals like ILBS Delhi, Fortis, or Medanta in Gurugram.

Centre for Hepatobiliary Diseases and Transplantation was established with the aim of offering specialised care, including liver transplants.

According to SGPGIMS’s own website, the idea for the centre was conceived in 2004. It was officially dedicated to the public by chief minister Yogi Adityanath on October 15, 2018.

The centre is housed in a six-storey building and offers a comprehensive 112-bed facility. This includes 60 surgical beds (covering Hepatobiliary surgery and transplant beds), 40 Hepatology beds (comprising acute liver ICU, paediatric hepatology ICU, and specialized pediatric liver care), as well as a liver dialysis bed, five transplant ICU beds, a high-dependency transplant unit, preoperative and postoperative care units, and a liver emergency receiving station.

The centre also boasts of a 120-seat auditorium, a full radiology suite, and four state-of-the-art operation theaters, making it a self-contained facility.

A department insider stated, “Liver transplant is the most challenging surgery—there is no surgery more difficult than this. Despite having state-of-the-art facilities for liver transplants, PGI lacks surgeons with the specialised skills required for such high-precision procedures. While we have a department dedicated to liver transplants, we need additional support for surgeries due to the limited expertise of our in-house surgeons. For example, ILBS Delhi has supported liver transplants performed at PGI. Furthermore, many of the patients seeking transplants are from underprivileged backgrounds, so financial assistance is also necessary, that’s why liver transplant surgeries in PGI are rare.”

Acknowledging the situation wherein only three liver transplants were done in five years, Professor Radha Krishna Dhiman, director of SGPGIMS, said he remains optimistic about the future of liver transplants at the institute.

He remarked, “PGI has successfully conducted transplants in the past, and we aim to increase the number of procedures. We will continue performing liver transplants at this premier institution.”

Repeated calls by HT to head of the department of gastro surgery Dr Anu Behari for a comment on the issue went unanswered.

DEPT OF GASTRO SURGERY TEAM

Besides Dr Anu Behari, the other members of the department of gastro surgery team include Professor Ashok Kumar, Professor Rajneesh Kumar Singh, Professor Ashok Kumar II, Additional Professor Supriya Sharma, Associate Professor Rahul, Associate Professor Ashish Kumar Singh, Assistant Professor Sinivas Biraveley , Assistant Professor Yash Vardan Sinha and Assistant Professor Kush Satyen Parikh.

EARLY SETBACKS

The liver transplant program at SGPGIMS has faced significant setbacks. The first liver transplant was performed in December 2000, followed by two more in early 2001 and 2002. While all three transplants were technically successful, the patients unfortunately succumbed to post-operative complications, with 16 out of 21 transplant recipients not surviving.

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