Our Renowned Multi-Visceral Team at MGM Healthcare

The highly specialized unit led by Prof. Dr. Anil Vaidya – Chairman and Director – Institute of Multi-Visceral and Abdominal Organ Transplant and his dedicated team.

Our team is equipped to handle a range of transplants including

Kindney

Kindney

Small Intestine

Small Intestine

Liver

Liver

Pancreas

Pancreas

Multi-Visceral Organ

Multi-Visceral Organ

Prof. Dr Anil Vaidya M.D

Chair and Director – Institute of Multi-Visceral and Abdominal Organ Transplant

Dr Dinesh Babu

Senior Consultant Anaesthesiology and Intensive Care Institute of Multi-Visceral and Abdominal Organ Transplant

Dr Nivash Chandrasekaran

Senior Consultant Anaesthesiology and Intensive Care Institute of Multi-Visceral and Abdominal Organ Transplant

Dr. Thiagarajan Srinivasan

Director – Institute of Liver Transplant and HPB Surgery

Dr.Karthik Mathivanan

Senior Consultant & Associate Director Institute of Liver Transplant and HPB Surgery

Dr Senthil. M

Senior Consultant Institute of Multi-Visceral and Abdominal Organ Transplant

Intestinal Failure

Causes and Implications

Intestinal failure refers to a condition in which the intestines are unable to fulfill their essential functions of digestion and absorption, leading to a reliance on alternative means of nutrition and medical intervention.

Functional Classification

Type 1 (Self-limiting)

Acute post – operative Ileus Acute inflammation

Type 2 (Prolonged)

GI complication

EC fistula

Abdominal Sepsis

Type 3 (long term)

Short Bowel Syndrome

Chronic Obstruction

Motility Disorder

Pathophysiological Classification

  • Short Bowel Syndrome(SBS)/Short Gut Syndrome
  • Intestinal Fistula
  • Intestinal Dysmotility
  • Mechanical Obstruction
  • Extensive small bowel mucosal disease.

Short Bowel Syndrome (SBS)/Short Gut Syndrome

Short Bowel syndrome is a condition when the intestine cannot perform its duties of absorbing orally taken nutrients and electrolytes.

This can happen due to a variety of reasons including:

The main consequence of SBS is a marked reduction of intestinal absorption surface and its main complication is undernutrition and hydro-electrolytic abnormalities. Total Parenteral Nutrition (PN), the major treatment of intestinal failure, has long-term complications.

The impact of SBS largely depends on the remaining intestinal anatomy. If a substantial portion of the jejunum is resected, absorption is generally not severely affected due to compensatory functions of the remaining ileum and colon. However, extensive ileal resection can lead to significant fat malabsorption, and if the colon is also resected, it can cause imbalances in fluid and electrolyte levels.

Motility Disorders
(Chronic Intestinal Pseudo-obstruction - CIPO):

Motility disorders, also known as CIPO, occur when the function of the small bowel, including its movement, becomes impaired, while the anatomy and length of the bowel remain intact. Symptoms can mimic bowel obstruction and include severe abdominal pain, distension, bloating, nausea, vomiting, and difficulty eating.

Intra-abdominal Non-Metastasizing Tumors:

In some cases, intestinal failure can be attributed to intra-abdominal tumors that progressively obstruct the bowel. Surgical removal of the tumor may require resecting the entire affected intestine, necessitating a transplant. These tumors grow locally and can impede the intestinal blood supply, leading to severe complications.

Other Causes:

Additional causes of intestinal failure in adults include ischemia (insufficient blood supply to the intestines), Crohn's disease (a chronic inflammatory bowel disorder), trauma (such as severe abdominal injuries), volvulus (twisting of the intestine causing obstruction)

Implications of Intestinal Failure

Intestinal failure poses significant challenges to affected individuals, including malnutrition, dehydration, electrolyte imbalances, and impaired quality of life. It often requires complex medical management, including specialized nutrition support (such as parenteral nutrition or enteral nutrition) and close monitoring of fluid and electrolyte levels. In severe cases, intestinal transplantation may be considered as an ideal treatment option.

Efforts to manage intestinal failure involve multidisciplinary teams comprising Gastroenterologists, Surgeons, Dietitians, Nurses, and other healthcare professionals. The goal is to optimize nutrition, manage symptoms, and minimize complications to enhance patient well-being and functionality.

Intestinal Rehabilitation Center at MGM Healthcare

The hallmark of managing intestinal failure, also known as intestinal rehabilitation, involves the intravenous delivery of nutrition and hydration, known as Total parenteral nutrition (TPN)

Total Parenteral Nutrition

Total-Parental-Nutrition

At our center, we have a specialised Total Parenteral Nutrition (TPN) rehabilitation unit that provides a tailored program for patients with short bowel syndrome followed by a transplant.

The treatment revolves around provision of NUTRITION through Total Parenteral Nutrition (TPN) and includes 5 crucial steps:

  • Placement of tunneled intravenous lines by a dedicated Interventional Radiology team
  • Prevention of infection of these lines with unique interventions only available at MGM Healthcare
  • Source control of sepsis associated with the cause of short gut syndrome by a specialized surgical team
  • Defining the anatomy of the intestine with state-of-the art radiology techniques.
  • Planning rehabilitation or transplantation in a multi-disciplinary fashion.

Multi-Visceral Transplant Center at MGM Healthcare

Type 3 Intestinal Failure is irreversible and necessitates long-term Total Parenteral Nutrition (TPN) before transplantation.

Various types of graft transplants are performed:

  • Isolated intestinal
  • Combined liver-intestinal and multi-visceral transplantation
  • Combined liver-intestinal grafts include intestine, duodenum, liver and pancreas
  • Multi-Visceral grafts include intestine, stomach, duodenum, pancreas, liver and colon, or other organs

Multi-Visceral Transplant Center at MGM Healthcare

The stepwise procedure for a multi-visceral transplant at MGM Healthcare is as follows:

Pre-transplant Evaluation

Before the transplantation procedure, an extensive evaluation is conducted to assess the patient's overall health and determine their eligibility for the transplant. This evaluation involves a series of medical tests, including blood work, imaging scans, and consultations with various specialists. The goal is to ensure that the patient is in optimal condition to undergo the transplant surgery.

Waiting Period

Once a patient is deemed suitable for a multi-visceral transplant, they are placed on the organ transplant waiting list. The waiting period can vary depending on organ availability and compatibility factors. During this time, the patient is closely monitored by the transplant team to ensure their well-being and readiness for the procedure

Surgery

When a suitable organ becomes available, the patient undergoes transplantation surgery. The procedure is typically performed under general anesthesia and can take several hours to complete. Skilled surgeons remove the diseased organs and replace them with the donated organs, ensuring meticulous attention to detail and precision

Post-transplant Care

Following the surgery, the patient is transferred to the intensive care unit (ICU) for close monitoring. They remain in the hospital for an extended period, usually several weeks, to ensure proper healing, organ function, and to prevent complications. The medical team administers medications to prevent organ rejection and manage pain during this critical phase of recovery

Recovery and Rehabilitation

Once the patient's condition stabilizes, they transition to a regular hospital room and, eventually, are discharged. However, the recovery process continues even after leaving the hospital. Patients are required to adhere to a strict medication regimen, attend frequent follow-up visits, and participate in rehabilitation programs to regain strength and function

Long-term Care

It is crucial to emphasize that multi-visceral transplantation necessitates lifelong management and care. Patients need to adhere to a specialized diet, take immunosuppressant medications as prescribed, and maintain regular contact with the transplant team. Periodic medical evaluations, including organ function tests and surveillance for potential complications, are essential to ensure the long-term success of the transplant and the patient's overall well-being.

The Multi-Visceral Transplant Center at MGM Healthcare, with its dedicated and experienced team, provides comprehensive and patient-centered care throughout the entire transplantation journey. The center's expertise, combined with a multidisciplinary approach, ensures the best possible outcomes for patients with Type 3 Intestinal Failure requiring a multi-visceral transplant.

Advanced Dual Transplant Technique: A Life-Changing Solution for Diabetes and Dialysis Patients 

Pineapple

MGM Healthcare is revolutionizing treatment for diabetes and dialysis patients with its dual organ transplant technique. By combining the pancreas and kidney transplant in a single procedure, Indian patients have a greater chance at a longer, healthier life. Diabetes is a serious concern in India, affecting millions of individuals due to genetic and lifestyle factors. Moreover, diabetes can lead to kidney failure and other life-threatening complications. Studies show that about 100 persons per million Indians suffer from both kidney failure and diabetes, calling for innovative solutions.

The Simultaneous Pancreas and Kidney (SPK) Transplant is MGM Healthcare’s gold standard of therapy for diabetic patients on dialysis. By selecting the right candidates, diabetes can be cured through transplantation, providing an enhanced quality of life and longevity.

One key advantage of the SPK transplant is the extended half-life of the transplanted organs. With a cadaveric-donor kidney transplant, the half-life is typically 7 years in India, while SPK technique extends it to 25 years or more, offering diabetic patients more than two decades of dialysis-free living.

The challenge lies in coordinating the transplantation process, especially when dealing with two organs. MGM Healthcare is working on structural changes to prioritize patients with dual organ requirements, ensuring that pancreas and kidney availability is better matched. This approach can significantly benefit a larger number of patients in the country.

MGM Healthcare's dedicated medical team, led by Dr. Anil Vaidya, - Chair and Director - Institute of Multi-visceral and Abdominal Organ Transplant, pioneer's techniques for monitoring the long-term acceptance of donor organs, resulting in better patient outcomes and improved quality of life.

With MGM Healthcare's advanced dual transplant technique, hope and a healthier future are within reach for the 132,000 Indians suffering from diabetes and dialysis. Together with a healthy lifestyle, this innovative solution promises a long, happy life for patients well into their retirement age.

Our Success Story

Where hope is found in difficult times

Successful simultaneous Kidney & Pancreas Transplant performed on 34-year-old by Dr Anil Vaidya, Director and Senior Consultant, Department of Multi-Visceral and Abdominal Organ Transplant and his dedicated team MGM Healthcare, Chennai

Small Bowel Transplant on a 46-year-old woman from Kerala by Dr Anil Vaidya, Director and Senior Consultant, Department of Multi-Visceral and Abdominal Organ Transplant and his dedicated team at MGM Healthcare, Chennai

Press Releases

We specialize in Multi-Visceral Transplants and Bowel rehabilitation, providing personalized care and support to patients throughout their recovery. Our team is dedicated to providing outstanding healthcare, fueled by the goal of Doing More, Better