Artemis Transplant Centre (Liver, Kidney, Cornea & Bone Marrow Transplant)
Bone marrow transplant & haemato oncology
Healthy marrow and blood cells are needed 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, transplant offers, the only potential cure but only about 25-30% patients have siblings who are eligible to be donors. We, at Artemis, are doing cord blood, unrelated donor and Haplo-identical (taking father or mother as donor) 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 healthy ones. Blood-forming cells are also called blood stem cells. Blood stem cells are immature cells that can grow into red blood cells, white blood cells and platelets.
There are two types of transplant:
Autologous transplant – It uses your own cells which are collected from the blood stream and stored for your transplant.
Allogeneic transplant - uses cells from a family member, unrelated donor or umbilical cord blood unit.
How Transplant Works?
We at Artemis have both adult & paediatric transplant physicians taking care of transplant patients. If you need a transplant, you will be referred to a doctor who specialises in bone marrow transplants. Your transplant doctor will talk to you about the type of transplant and cell source that 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 and their quality of life improved after transplant.
The three sources of blood-forming cells used in transplants are:
- Bone Marrow
- Peripheral (circulating) blood (also called peripheral blood stem cell or PBSC)
- Umbilical cord blood collected after a baby is born
Bone Marrow Transplant is the only cure for Thalassaemia, Aplastic Anaemia, Leukaemia (Blood Cancer), Lymphoma and Immunodeficiencies.
Team of specialists:
Bone Marrow Transplant & Hemato Oncology
Dr. Pawan Kumar Singh - Consultant - Haemato Oncology (Adult) & Bone Marrow Transplant
Dr. Ragesh Radhakrishnan Nair - Associate Consultant - Haemato Oncology (Adult) & Bone Marrow Transplant
What is Cornea?
Cornea is the transparent part of the eye in front which allows light to enter the eye and helps in forming a clear image.
What is corneal transplantation?
A corneal transplant involves replacement of a damaged cornea with a healthy one from a donor
An unhealthy cornea affects the vision by either not allowing light to enter the eye or causing significant scattering or distortion of light. This causes blurry vision. A cornea transplant is required in these cases to restore functional vision.
Sometimes diseases of the cornea including infections can cause significant weakening of the cornea. In these cases corneal transplants are performed in order to protect the integrity of the eye, relieve pain and remove the diseased cornea.
Who all can benefit from corneal transplantation?
Corneal transplantation may be required in various eye diseases which can include the following:
• Opacities in cornea due to previous infections such as corneal ulcer, herpes of the eye or eye injury.
• Keratoconus and other similar diseases which result in thinning and irregular shape of the cornea.
• Hereditary diseases of the cornea.
• Corneal failure (Bullous Keratopathy) from previous surgeries or injuries causing edema (fluid collection).
• Complications of Excimer laser surgeries.
• Chemical burns on the cornea.
Apart from the eye disease itself, other factors that should be considered are the vision in the other eye, patient's ability to follow a prolonged and strict follow-up schedule and the patient’s ability to report early to a medical facility in case of graft rejection?
All of these factors, in conjunction with thorough discussions and screening with the eye doctor, must be weighed before a final decision is made to have a corneal transplant.
Procedure for a corneal transplant?
Once it's decided that a corneal transplant is required, the patient's name is listed at a registered centre. The Eye Bank collects eyes from donors and processes the tissue for use. The tissue is checked for clarity and any diseases. The donor is also meticulously screened for diseases such as hepatitis, syphilis and HIV to ensure the health and safety of the recipient.
Corneal transplants are usually under local anaesthesia as a daycare procedure and lasts approx 1-2 hours. During the 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 some cases cataract removal and implantation of IOL may be required in addition to the corneal transplantation. The donor corneal button is sutured with fine sutures to keep it in place.
Recovery period after surgery?
Initially the vision is blurry after the surgery but will gradually continue to improve for up to a year.
Heavy exercise and lifting are prohibited for the first few weeks. However the patient can return to normal daily activities and start professional work within 1-2 weeks after surgery.
Eye drops will be prescribed for several months to years to prevent the body from rejecting the foreign tissue. Stitches are usually removed slowly over many months starting from three months after surgery depending on the health of the eye and wound healing.
Even though corneal transplant improves vision, correction with glasses or contact lenses is required for optimal vision. Since the vision usually fluctuates during the first few months and changes after every suture removal/adjustment, it is desirable to wait for some time for the final prescription.
Graft Rejection - The body's immune system attempts to damage it as it sees it as a foreign body. Most corneal transplants are successful but graft rejection can occur in about 20% of cases. Recognizing the early warning signs of graft rejection followed by immediate treatment with medicines is the best way 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 (DSEK). Unlike a traditional keratoplasty, DSEK involves the transplant of only a thin back layer of cornea. This surgery involves only minimal suturing (1-2 sutures compared to 16-24 sutures in a traditional keratoplasty) and thus allows a much faster visual recovery.
EYE DONATION (A noble cause)
There are an estimated 4.6 million people with corneal blindness in India waiting for a corneal transplant. 90% of these are below 45 years of age including 60% below the tender age of 12 years. Eye donations by you or your beloved can make a big difference to the lives of atleast 2 people.
Who can be eye donors?
Eye donation can only be done after death. Practically anybody above 1 year of age can donate without any upper age limit. Even people with poor eyesight, old age, spectacles, cataract surgery, diabetes and blood pressure can also donate their eyes. Even a person who is blind from retinal or optic nerve disease can donate eyes.
Persons who cannot donate their eyes are those who have died of unknown causes, or due to infectious rabies, syphilis, infectious hepatitis, septicemia, 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 that would interfere with common funeral practices.
I want to donate my eyes. What should I do?
All one needs 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.
While taking a pledge during one’s lifetime itself is a noble deed, it is worthless if the relatives or friends don’t call an eye bank after death. They need to 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 eye bank personnel will reach at your place to collect the eyes.
The eyes should be collected soon after death and the sooner the better. Though the quality of the eye deteriorates with time, the best time is within 6 hours after death. Under some circumstances it may even be taken till 12 hours after death. In case of any doubt discuss with the eye bank personnel regarding possibility of donation.
Till the time eye bank team reaches, a few precautions needs to be taken to prevent damage to the eyes. These include
• Both eyes of the deceased need to be closed and covered with moist cotton.
• The ceiling fan above the body should be switched off
• The body should be kept at as low temperature as possible. Thought not mandatory, is better if ice blocks or air conditioners are used to keep the body cool.
• The head should be raised above the level of the body
Will the recipient be informed of the donor’s details?
As per 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?
A dedicated number of 1919 (from MTNL / BSNL phones) can be used to contact the local eye bank where functional. The phone number for Artemis Eye Centre is 0124-6767999. You may also contact Dr. Sameer Kaushal (Mob 9312009486) for any further clarifications.
Team of specialists:
Dr. Sameer Kaushal – Head
Liver transplant & gi surgery
Liver transplantation is the surgical replacement of a diseased liver with a healthy liver. The indication for this operation is end-stage liver disease, characterized by patients suffering from reduced liver function, muscle loss, fatigue, and encephalopathy, signs of portal hypertension, poor blood clotting and jaundice. A variety of liver diseases can lead to end-stage liver disease. There are generally two main categories: those cases caused by viruses (Hepatitis B and C) and/or alcohol and those caused by problems concerning the bile ducts (primary biliary cirrhosis and primary sclerosing cholangitis).
After an evaluation is completed, the patient is placed on the liver transplant waiting list. In India ORBO (Organ Banking and Retrieval Organisation) and MOHAN (Multi Organ Harvesting and Networking) promote organ donation and facilitate distribution of cadaveric livers. In the case of a cadaveric donor organ, the transplant center receives a liver offer from ORBO for a specified patient.
There are different sources of donor livers. Usually the liver is obtained from a cadaveric donor (a person diagnosed as "brain dead" but whose other organs and systems are functioning properly). Due to a continuous shortage of donor livers and the high incidence of liver disease, the waiting time is increasing every year. Hundreds of people die each year while waiting for a cadaveric liver to be offered. Donor livers also can be obtained from a family member or a friend who donates a portion of his/her liver to the patient (see living-related donor).
In the case of a cadaveric donor organ, the transplant center receives a liver offer from ORBO for a specified patient. 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. The operation usually takes 6-8 hours. After the operation the patient begins taking medications to prevent the new liver from being rejected by the body. Complete recovery may take several weeks. The quality of life for the transplant patients usually improve dramatically and most lead healthy, normal lives.
Team of specialists:
Liver Transplant & GI Surgery
Dr. Ramdip Ray- Additional Director - Liver Transplant & Sr. Consultant - GI & HPB Surgery - Liver Transplant
Dr. Giriraj Singh Bora - Additional Director - Liver Transplant & Sr. Consultant - GI & HPB Surgery
Dr. Shyam Sunder Mahansaria - Consultant
Dr. Harsha Jauhari is the renowned transplant surgeon at our center. He is a leading transplant surgeon in India; he was trained in U.K. and is also head of transplant services at Sir Gangaram Hospital.
Kidney transplant is a surgical procedure in which a kidney from either a healthy living donor or deceased donor (cadaver) is implanted in to the renal failure patient. Kidney transplant has many limitations like arranging for a kidney from relatives or close friends. This at times becomes a Herculean task. Alternatively, the patients can live on dialysis. It is very important to understand that without dialysis or transplant, the end stage kidney patient cannot survive at all. So although dialysis is expensive, at times painful and time consuming but it is the only way to live for many years in the face of ESRD.
Team of specialists:
Dr. Harsha Jauhari - Sr. Consultant