Times of India
08 April 2010
By Malathy Iyer
Mumbai, India

The shiny, white bicycle parked outside the Waigankars’ modest home in Dombivli is a health statement: it loudly states that their nine–year–old daughter Shivani has recovered well enough from a life–threatening condition to cycle confidently on the roads.

Shivani, who was born with a liver defect, underwent a transplant four years ago. She is one of the 30–odd patients who has undergone a liver transplant –acknowledged as one the most complicated surgeries in the medical field– within the city. Liver transplants have indeed come a long way in Mumbai. From a phase when liver failure patients either had to live with the disease or rush abroad for expensive transplants, there is now a local solution.

This was the gist of the function held on Wednesday at Jaslok Hospital to commemorate its 26th liver transplant surgery. “Liver transplantation is now a life–saving surgery offering a better quality of life to some,” said hepatologist Dr Aabha Nagral. Most importantly, she said, “Many of our patients are long–term survivors leading normal lives.” One of their patients, Prannay Pujari, who was present at Wednesday’s function, participated in a fashion show and stood first.

Shivani’s father Manish concurs. “There was a phase when Shivani would vomit blood, undergo frequent blood tests or need oxygen cylinders,” he said. Without insurance to pay for the twin surgeries in the family, the young parents had a tough time gathering the Rs 6–lakh medical bill. “But it has been worth the effort to see Shivani going to school like other children,” said Manish.

Jaslok’s transplant surgeon Dr Sanjay Nagral said, “We have had good results with both live donors as well as cadaver donation. The long–term effectiveness of liver transplants can no longer be questioned.”

Consider the case of teenager Vivek (name changed), who doesn’t miss his gully cricket. His father Vinay (name changed) is indulgent because his son has lost a lot of play time while dealing with the complications of Wilson’s Disease (in which the liver cannot absorb copper, leading to its toxic accumulation). “He suffered a great deal as his liver was permanently damaged. He visited hospitals regularly, but after the transplant, he is like any other youngster,” said his father.

City Acquires An Edge
Considering that one in 700 persons reportedly suffers from liver failure, there is a huge patient pool that could benefit. Three hospitals in Mumbai have a liver transplant programme–Jaslok Hospital in Pedder Road, Wockhardt Hospital in Mulund and Hinduja Hospital in Mahim. Also, KEM Hospital is likely to unveil its new operation theatre for liver transplant in the next month. What makes Mumbai interesting is the price tag. When the BMC announced its plans for a liver transplant programme nine months ago, KEM Hospital dean Dr Sanjay Oak had said that he would perform the transplants in Rs 5 lakh to Rs 7 lakh. Jaslok Hospital performs the operation for Rs 8 lakh to Rs 12 lakh. In contrast, Delhi’s hospitals–which have performed 500 liver transplants –charge over Rs 20 lakh.

Could Mumbai emerge as the affordable option? It would seem so, but there is scepticism as well. “There is poor awareness even among doctors about liver transplants, leading to only a few patients registering for it. There also are few donors as cadaver donations haven’t picked up. Moreover, only a handful of hospitals have the infrastructure to maintain cadavers till organs are retrieved,” said Dr Nilesh Doctor, who is a liver transplant surgeon from Jaslok Hospital.