Artemis Transplant Centre (Liver, Kidney, Cornea & Bone Marrow Transplant)
Bone Marrow Transplant & Haemato Oncology
Healthy marrow and blood cells are required to live. Disease can affect the marrow’s ability to function. When this happens, a bone marrow or cord blood transplant could be the best treatment option. For some diseases, the transplant offers the only potential cure but only around 25-30% patients have siblings who are eligible to be donors.
At Artemis, we are doing cord blood, unrelated donor and Haplo-identical i.e. taking father or mother as donor for transplant so that all the patients who need transplant can have a donor. A bone marrow or cord blood transplant replaces unhealthy blood forming cells with the healthy ones. The blood forming cells as also called as the blood stem cells which are immature cells that can grow into the red blood cells, white blood cells and platelets.
There are two types of transplant:
- Autologous transplant
It uses your own cells collected from the blood stream and stored for your transplant.
- Allogenic transplant
It uses cells from a family member, unrelated donor or umbilical cord blood unit.
How Transplant Works?
At Artemis, we have both the adult and paediatric transplant physicians who take care of the transplant patients. If you need a transplant, then you will be referred to a doctor who specialises in the bone marrow transplants. Your transplant doctor will talk to you about the type of transplant and cell source which is most likely to work best for you based on your disease and other health factors.
Life After Transplant
It can take as long as a year for the new bone marrow to function normally. Most patients have improved their quality of life after transplant.
The three sources of blood forming cells used in transplants are:
- Bone marrow
- Peripheral blood also called peripheral blood stem cell or PBSC
- Umbilical cord blood collected after a baby is born
The bone marrow transplant is the only cure for Aplastic Anaemia, Thalassaemia, Lymphoma, Leukemia or blood cancer and immunodeficiencies.
Our Team of Specialists
Bone Marrow Transplant & Hemato Oncology
Dr. Rahul Bhargava- Sr. Consultant
Dr. Vikas Dua- Consultant (Paediatrics)
Dr. Aniruddha Purushottam Dayama
What is Cornea?
Cornea is the transparent part of the eye in front that allows the light to enter the eye and helps in forming a clear image.
What is Corneal Transplantation?
It involves replacing a damaged cornea with a healthy one from a donor.
An unhealthy cornea affects the vision either by not allowing the light to enter the eye or causing significant scattering or distortion of the light. This will cause blurry vision. A cornea transplant is needed in such cases to restore the functional vision.
Sometimes diseases of the cornea such as infections can cause significant weakening of the cornea. In such cases, the corneal transplants are done to protect the integrity of the eye, relieve pain and remove the diseased cornea.
Who all can benefit from corneal transplantation?
A corneal transplantation is needed in various eye diseases which include the following:
- Keratoconus and other similar diseases that result in thinning and irregular shape of the cornea
- Opacities in cornea due to previous infections such as herpes of the eye, corneal ulcer or eye injury
- Hereditary diseases of the cornea
- Chemical burns on the cornea
- Complications of Excimer laser surgeries
- Corneal facilure or Bullous Keratopathy from previous surgeries or injuries causing edema or fluid collection
Apart from the eye disease itself, other factors to be considered are the patient’s ability to follow a prolonged and strict follow-up schedule, the vision in the other eye and the patient’s ability to report to a medical facility in case of graft rejection.
You must weigh all of these factors in conjunction with thorough discussion and screening with the eye doctor before making a final decision to have a corneal transplant.
Procedure for a Corneal Transplant
Once it is decided that a corneal transplant is needed, the patient’s name is listed at a registered centre. The Eye Bank collects the eyes from donors and processes the tissue for use. The tissue will be checked for clarity and any diseases. The donor is also meticulously screened for diseases such as syphilis, hepatitis and HIV to ensure safety and health of the recipient.
Corneal transplants are usually done under local anaesthesia as a day-care procedure and it lasts for about one to two hours. During this surgery, a round, button shaped section of tissue is removed from the eye and replaced with a nearly identical shaped button from the donor tissue. In certain cases, the cataract removal and implantation of IOL may be needed in addition to the corneal transplantation. The donor corneal button is sutured with fine sutures to keep it in place.
Recovery Period Post Surgery
Initially the vision is blurry after the surgery but it will gradually continue to improve for up to a year. For the first few weeks, heavy exercises and lifting are prohibited. However, the patient can return to normally daily activities and stay their professional work within one to two weeks post surgery.
You will be prescribed with eye drops for several months to years to prevent the body from rejecting the foreign tissue. Usually, the stitches are removed slowly over many months starting from three months post surgery, depending on the health of the eye and wound healing.
Although the corneal transplant improves vision, correction with the glasses or contact lenses is required for optimal vision. Since the vision will usually fluctuate during the first few months and changes after every suture removal or adjustment, it is desirable to wait for some time for the final prescription.
Graft Rejection- The body’s immune system attempts to damage it since it sees it as a foreign body. Most of the corneal transplants are successful but the graft rejection may occur in around 20% of the cases. It is therefore important to recognize the early warning signs of graft rejection to follow with immediate treatments with medicines in order to prevent a complete graft failure due to rejection.
What is DSEK?
It is a new version of corneal transplant known as Descemet’s Stripping Endothelial Keratoplasty (DESK) which involves the transplant of only a thin back layer of cornea. This surgery includes only the minimal suturing i.e. 1-2 sutures as compared to the 16-24 sutures in a traditional keratoplasty therefore it allows a much quick visual recovery.
EYE DONATION (A Noble Cause)
There are an estimated 4.6 million people with corneal blindness in India who are waiting for a corneal transplant. Around 90% of these are below 45 years of age including 60% of them below the tender age of 12 years. Eye donations by you or your beloved can make a huge difference to the lives of at least two people.
Who can be eye donors?
The eye donation can only be done after death. Practically, anybody above one year of age can donate without any upper age limit. Even people with poor eyesight, spectacles, old age, diabetes, cataract surgery and blood pressure can donate their eyes. Also a person who is blind from retinal or optic never disease can donate their eyes.
Persons who cannot donate their eyes are those who have died of unknown causes, syphilis, infectious rabies, septicaemia, infectious hepatitis and AIDS.
Will eye donation cause delays in funeral arrangement?
No, Eye removal itself takes only 15-20 minutes and does not cause any disfigurement which would interfere with common funeral practices.
I want to donate my eyes. What should I do?
All you need to do is tell your relatives and friends about your desire to donate eyes. You can also sign a simple pledge form available at any eye bank. Taking a pledge during one’s lifetime itself is a noble deed, but it is worthless if the relatives or friends don’t call an eye bank after death. They should call up the Eye Bank as soon as possible after death so that the eye can be obtained and preserved.
Can the next of kin donate eyes of a relative if the deceased person had not signed an eye donation form?
Yes, the relatives of the deceased can decide on the eye donation of their beloved one.
What is the process of donation after death?
The first step is to call the nearest eye bank and inform them about your desire to donate. A team of the eye bank personnel will reach at your place to collect the eyes.
The eyes should be collected soon after the death since the sooner the better. Though the quality of the eye deteriorates with time, the best time is within six hours after death. Under certain circumstances, it may even be taken till 12 hours after death. Discuss with the eye bank personnel in case of any doubt regarding the possibility of donation.
Till the time, the eye bank team reaches, take the following precautions to prevent damage to the eyes:
- Both eyes of the deceased should be closed and covered with moist cotton
- The body should be kept at as low temperature as possible. Though not mandatory, better if ice blocks or air conditioners are used to keep the body cool
- The ceiling fan above the body should be switched off
- The head should be raised above the level of the body
Will the recipient be informed of the donor’s details?
As per the law, no information of the recipient or the donor is passed on to each other.
Whom Should I contact in case somebody wants to donate eyes of the deceased?
You can contact our International Helpline Number +91-93235887033 for any further clarifications.
Our Team of Specialists
Dr. Sameer Kaushal- Sr. Consultant
Liver Transplant & GI Surgery
Liver transplantation is the surgical replacement of a diseased liver with a healthy liver. The indication for this operation is the end-stage liver disease which is characterized by the patients suffering from reduced liver function, fatigue, muscle loss and encephalopathy, poor blood clotting, signs of portal hypertension and jaundice. A variety of liver diseases can lead to the end-stage liver disease. Generally, there are two main categories: cases causes by viruses (Hepatitis B and C) and/or alcohol and those caused by problems concerning the bile ducts i.e. the primary biliary cirrhosis and primary sclerosing cholangitis.
After completion of evaluation, the patient is placed on the liver transplant waiting list. In India, MOHAN (Multi Organ Harvesting and Networking) and ORBO (Organ Banking and Retrieval Organisation) promote organ donation and facilitate distribution of cadaveric livers. In case of a cadaveric donor organ, the transplant center receives a liver offer from the ORBO for a specified patient.
There are different sources of donor liver: often the liver is obtained from a cadaveric donor i.e. a person diagnosed as brain dead but whose other organs and systems are functioning properly. Th waiting time is increasing each year, due to a continous shortage of donor livers and high incidences of liver diseases. Around hundreds of people die every year while waiting for a cadaveric liver. The donor livers can also be obtained from a family member or a friend who donates a portion of his/her liver to the patient.
In case of a cadaveric donor organ, the transplant centre receives a liver offer from ORBO for a specified patient. Then the patient is notified and admitted to the hospital. The patient is then notified and admitted to the hospital.
While the donor team is procuring the donor liver, the recipient team begins to prepare the patient. The diseased liver is removed and the healthy liver is put in its place. Usually, the operation takes around 6-8 hours. After the operation, the patient starts taking medications to prevent the new liver from being rejected by the body. Complete recovery will take several weeks. Usually, the quality of life for the transplant patients improves dramatically and most of them lead healthy and normal lives.
Our Team of Specialists
Liver Transplant & GI Surgery
Dr. Ramdip Ray- Sr. Consultant
Dr. Giriraj Bora- Consultant
Dr. Ravi Chand- Consultant
Dr. Shishir Pareek- Consultant
Dr. Md. Nayeem- Consultant
Dr. Neerav Goyal- Sr. Consultant
Dr. Shaleen Agarwal- Sr. Consultant
Prof. Subhash Gupta- Director
Kidney transplant is a surgical procedure in which a kidney from either a healthy living donor or decreased donor or cadaver is implanted in to the renal failure patient. Renal transplant has many limitations such as arranging for a kidney from relatives or close friends. At times, this is a Herculean task. Alternatively, patients can also live on dialysis. It is quite significant to understand that without dialysis or transplant, the end stage kidney patient cannot survive at all. Therefore, although the dialysis is expensive, at times it is painful and time consuming but it is the only way to live for many years in the face of ESRD.
Dr. Harsha Jauhari is the renowned transplant surgeon at our centre and the leading transplant surgeon in India. He was trained in the UK and is also the head of the transplant services at Sir Gangaram Hospital.
Our Team of Specialists
Dr. Harsha Jauhari- Sr. Consultant
Dr. Pradeep Bansal- Consultant