On one liver, two lives: rare split transplant saves man, toddler in Mumbai

“I had almost lost hope after waiting for years. Living with liver disease was physically exhausting and mentally draining. Watching my body grow weaker while waiting for a transplant was frightening,” Chavan said.

The second recipient, three year old Charvik Ingle from Nerul in Navi Mumbai, had been diagnosed with cryptogenic cirrhosis, a rare form of liver failure in which the exact cause remains unknown despite extensive testing. The illness had severely affected his growth, with his height and weight comparable to that of a one to two year old child.

“We were shattered when we learned our child had liver failure. Every hospital visit filled us with fear. When doctors said a transplant was the only solution, we were scared but hopeful,” said Charvik’s father, Dhanraj Ingle.

The transplant became possible after a 38 year old man was declared brain dead at AIMS Hospital in Dombivli, a centre accredited only for kidney transplants. Since the hospital does not perform liver transplants, the organ was allocated to the Mumbai pool under the Zonal Transplant Coordination Centre (ZTCC) guidelines.

Doctors said the donor met strict criteria required for a split liver transplant, including young age, stable clinical condition and normal liver function.

“The donor was relatively young with excellent liver function. After evaluating the organ, we decided to proceed with a split liver transplantation, which is a highly specialised and technically demanding procedure,” said Dr Anurag Shrimal, Director of Liver Transplant at Gleneagles Hospital, Parel.

As AIMS Hospital lacked the equipment needed to divide the liver, the transplant team transported specialised surgical instruments to Dombivli. The donor surgery was carried out on February 9.

The liver was divided into two portions the right trisection for the adult recipient and the left lateral segment for the child. The recipient surgeries were performed between February 9 and February 10.

“Multiple surgical teams worked simultaneously. Separate operating theatres were prepared for both recipients, and an additional theatre was used for the final stage of splitting before implantation. The entire effort lasted about 15 to 17 hours,” Dr Shrimal said.

Both patients recovered well after surgery. Chavan was discharged on February 21, while Charvik was discharged on February 28.

Dr S K Mathur, president of ZTCC, said paediatric donors remain extremely scarce in India, making split liver transplants particularly valuable.

“Children waiting for liver transplants often fail to get size matched organs in time. In many Western countries, one donor liver is routinely split to save an adult and a child, but this technique is still rarely used in India,” he said.

To address this, the ZTCC liver technical committee has prepared guidelines encouraging the splitting of suitable donor livers so that one organ can benefit both an adult and a child.

Doctors said such procedures remain uncommon because only a small proportion of brain dead donors meet the strict medical criteria required for splitting the liver.

In private hospitals, the transplant typically costs around ₹16.5 lakh for paediatric patients and about ₹19.5 lakh for adults, though the final expense varies depending on the patient’s condition and duration of hospital stay.