Gurgaon: Doctors at Paras Hospital successfully carried out a complex surgery combining a living donor liver transplant with a double heart valve procedure, a clinical first, according to the team. The 17-hour operation was performed on March 26 on 55-year-old Anara M from Kyrgyzstan, who had end-stage autoimmune liver disease alongside severe mitral and tricuspid valve dysfunction. She had been in and out of hospitals for years and came to Paras Hospital on February 25 seeking urgent advanced care. A multidisciplinary assessment found that both procedures, a liver transplant and double valve repair, were critical to saving her life. However, attempting both in a single sitting posed a significant surgical risk. A team of nearly 20 specialists, including liver transplant surgeons, cardiac surgeons, anaesthetists, and critical care staff, undertook the marathon surgery. The operation began with a four-hour heart procedure, during which doctors replaced Anara’s mitral valve and repaired the tricuspid valve. In a rare intraoperative decision, doctors then awakened the patient mid-surgery to assess her heart function in real time. Once the heart was deemed stable, the team proceeded with the liver transplant — a 12-hour procedure performed in the same session. “It is the first time anyone has combined a living donor liver transplant with simultaneous mitral and tricuspid valve repair,” said Dr Vaibhaw Kumar, director, Institute of Liver Transplant and GI Surgery at Paras Health Gurugram.“Our team carried out the liver transplant with great precision and deep anatomical knowledge. By doing double valve repair at the same time, we increased the risk and complexity significantly. Completing both procedures in one session demonstrates our surgical skill and the strength of our collaborative approach. We have set a new standard for what can be done in modern transplant and cardiac surgery,” he added. Dr Sanjay Kumar, vice chairman, Cardiac Surgery at Paras Health Gurugram, said the case was extremely rare and high-risk. “The patient had severe dysfunction of both the mitral and tricuspid valves. This meant that unless her heart was stabilised first, the liver transplant would not have been possible,” he said. “Successfully replacing the mitral valve and repairing the tricuspid valve allowed the transplant team to move forward with confidence. This achievement shows the strong teamwork between the cardiac and liver teams, the hospital’s infrastructure, and our dedication to providing patients a second chance at life.” The liver donor was Anara’s 23-year-old nephew. He was discharged five days after surgery and returned to Kyrgyzstan within three weeks, having fully recovered and resumed work. Anara spent eight days in intensive care and seven in recovery before being discharged on the 15th day. She returned home after six weeks and has since resumed a healthy, normal lifestyle.
