Gleneagles Hospital Chennai Performs Landmark Liver Transplant on 39-Year-Old Patient with Major Heart Defect
~ The patient had a significant leak in the aortic valve, making the liver transplant more challenging ~
Chennai, March 20, 2025: A multidisciplinary team at Gleneagles Hospital Chennai successfully carried out a lifesaving liver transplant for Mr. Kumaraswamy R, a 39-year-old patient from Chennai diagnosed with end-stage liver disease and severe cardiac complications. Mr. Kumaraswamy had a severely leaking aortic valve and unstable heart function, which raised concerns about his ability to endure the intense stress of transplant surgery and the subsequent recovery. Under the leadership of Dr. Joy Varghese, Director of Hepatology and Transplant, the complex liver transplant was performed using a liver donated by the patient’s wife, and the surgery lasted eight hours.
Mr. Kumaraswamy was diagnosed with chronic liver disease in 2021 when he presented with jaundice and fluid buildup in his abdomen. He endured multiple hospital admissions due to liver decompensations, including altered consciousness and kidney dysfunction. As his health worsened, he was referred to Gleneagles Hospital in Chennai in September 2024. A preoperative evaluation revealed a significant leak in the aortic valve, complicating matters since he was also in a very frail state before the transplant. Typically, patients with severe leaks in heart valves must resolve these issues through surgery or intervention before undergoing major surgery. However, because of the advanced nature of Mr. Kumaraswamy’s liver disease, an aortic valve replacement could not be performed.
A multidisciplinary team of specialists in liver anaesthesiology, critical care, transplant surgery hepatology, and cardiology developed a comprehensive liver transplantation strategy. Despite the increased right heart pressure and severe aortic regurgitation, the team opted to proceed with the transplant while carefully monitoring and managing the associated risks. A thorough preoperative evaluation was conducted, which included a right heart study and an aortogram for risk assessment and optimisation.
The liver transplant was successfully performed in October 2024. Mr. Kumaraswamy regained his independent mobility and was discharged from the hospital in stable condition. After a couple of months of recovery, the patient is now enjoying a normal, healthy life.
Dr Selvakumar Malleeswaran, Senior Consultant and Head of Liver Transplant Critical Care and Anaesthesiology, stated, “During the transplantation, we employed advanced monitoring techniques, including transesophageal echocardiography and pulmonary artery catheterization, to dynamically assess the patient’s cardiac status and make timely treatment decisions. Managing the increased right heart pressure and blood volume while maintaining blood flow to the liver was crucial during the procedure.”
“This was one of the most challenging transplant cases we have encountered. The liver transplant surgery was managed meticulously in several stages and coordinating the care of both cardiac and liver conditions required seamless cooperation among specialists,” said Dr. Joy Vargheese, Director of Hepatology and Transplant at Gleneagles Hospital Chennai.
Dr. Nageshwar Rao, CEO of Gleneagles Hospital Chennai, stated, “This case exemplifies our hospital’s commitment to excellence. Through seamless collaboration across multiple disciplines and advanced medical expertise, we successfully managed Mr. Kumaraswamy’s severe comorbidities. Our innovative approach has given him a second chance at life, underscoring our dedication to transforming patient care.”
