Swap Liver Transplant at Medicover Helps Two Patients Overcome Donor Incompatibility

Two men, 53-year-old businessman Mahendra Gamre and 41-year-old working professional Pawan Thigle, with end-stage liver disease, recently got a second chance at life through a swap liver transplant performed at Medicover Hospitals, Navi Mumbai. The surgeries were conducted earlier this month, with both patients and their donor wives now discharged after recovery. In this rare procedure, two wives donated portions of their livers—but instead of donating directly to their own husbands, they donated to each other’s spouses due to blood group mismatch.

Why a Swap Was Needed

Liver transplantation is often the last option when the liver can no longer perform its essential functions, such as detoxification, metabolism, and bile production. While living donor liver transplants are common in India, the donor and recipient must be medically compatible. Blood group mismatch is one of the main barriers.

In this case, both women—Juhi Gamre and Bhavana Thigle, aged 41 and 38 respectively—volunteered to donate part of their liver to their husbands but were found incompatible. Instead of waiting for a deceased donor, which could take months, doctors suggested a “swap transplant.” Here, each donor gave to the other recipient, overcoming the incompatibility issue and making the surgeries possible.

Inside the Surgery

The hospital coordinated four simultaneous surgeries, which lasted nearly 10–12 hours. The team, led by Dr. Sharan Narute, worked across multiple operating theatres to ensure precision and timing. Both donors happened to have two portal veins—a rare anatomical variation. Surgeons had to carefully reconstruct these veins during transplantation, adding complexity to the procedure.

Despite the challenges, both donors recovered enough to leave the hospital within a week, while the recipients were discharged after about 11 days. Their recovery involved close monitoring of liver function, pain management, and early mobilization.

Understanding the Science

The liver is unique among organs because it can regenerate after a portion is removed. This makes living donor transplantation possible. In adults, typically 40–60% of the donor’s liver is transplanted. Within weeks, the liver of both donor and recipient grows back to near-normal size.

However, transplant recipients must take lifelong immunosuppressive medicines to prevent their body from rejecting the new organ. They also require strict follow-up to monitor for complications such as infection, vascular issues, or rejection. For donors, long-term outcomes are generally positive when the surgery is performed at an experienced center.

Broader Significance

India faces a severe gap between the number of patients needing liver transplants and the availability of organs from deceased donors. Living donor and swap transplantation programs help bridge this gap, particularly when time is critical for patients with advanced disease.

The Medicover case shows how careful planning, multidisciplinary teamwork, and donor willingness can overcome incompatibility challenges. It also highlights the importance of public awareness about organ donation—both living and deceased—as a way to expand the pool of available organs.

(Rh/Eth/SS/MSM)