The Neurology department of Apollomedics Super Specialty Hospital, Lucknow saved the life of an aneurysm patient by performing a critical surgery. Dr Ravi Shankar, said that a 35-year-old Mr. Manoj Verma, a resident of Barabanki, was referred to the Apollomedics Hospital in a critical condition and was brought to the hospital in unconscious state. Dr. Ravi Shankar further added that in Brain Aneurysm, a balloon of blood had formed in the patient’s blood vessel. This was treated by Craniotomy and Clipping of Aneurysm in which the blood balloon in the vessel was closed by a clip. In this type of case, mortality rate is higher even after surgery. We found in reports that a balloon was formed in the dominant portion of the brain near two vessels which was arising from main blood vessel. The Aneurysm was attached to the vessels. In this condition, there was a possibility of blockage or damage of the vessels which could lead to inability to understand think & speak. Also, there is possibility of patient’s right side getting paralysed or even death. Therefore, firstly, we decided to contract the Aneurysm (balloon). During this 7 hours long operation, we stopped the patient’s heart beat for about 45 seconds, 4 times and took the patient into the state of temporary death (cardiac arrest). In this process, we had to work at a speed 100 times faster than normal surgical speed which requires special skills & training. Post-surgery, the patient recovered and started speaking immediately after the operation. Dr. Ravi Shankar said that the cause of the disease could have been due to hereditary reasons, excessive smoking and drinking. The symptoms of this disease could not be identified initially. In most of the cases, it is diagnosed after the explosion of aneurysm or balloon, which results to unconsciousness or coma. 50% of patients suffering from this, die before reaching the hospital. Dr. Sushil Gattani, Chairman of Apollomedics Super Specialty Hospital, gave credit of this successful surgery to the entire team and said that their first objective is to provide world-class medical facilities to every patient coming to Apollo Medics Super Specialty Hospital. This is the first time in Lucknow where such type of surgery has been successfully performed.

The team of doctors at Indraprastha Apollo Hospitals, Delhi successfully performed a dual lobe liver transplant on a patient from Yemen, in which parts of liver from two donors were grafted in to the recipient’s body. Mr. Al Naqeeb, a Yemeni national patient who was suffering from end-stage liver disease, was told by doctors that he needed a liver transplant. All three of his children offered to donate a part of their organ to save their father. However, as Mr. Naqeeb’s son was obese, he was ruled out as a potential donor. On the request of family, the doctors at Indraprastha Apollo Hospitals, Delhi started investigating Mr. Naqeeb’s daughters — Bahaja and Sarah, for organ donation. For liver transplants in cases of living donors, a patient’s diseased liver is replaced with a partial healthy liver from another person. In a typical adult recipient, 55% to 70% of the liver (the right lobe) is removed from a healthy living donor. The donor’s liver regenerates approaching 100% function within four to six weeks. However, in this case, investigation reports revealed that both daughters, who are in their 20s, had less than the required volume of liver. Hence, the doctors could not perform the transplant with either girl as donor. Since there were no other donors, the daughters insisted that doctors explore if they could both donate parts of their liver, which could be used together for the transplant. “Dual lobe liver transplant is possible, but it is more complex. Because we didn’t have any other option to save the patient’s life, we give it a chance and succeeded,” said Dr Goyal, Senior Consultant , Liver Transplant at the hospital. He explained that they took out the right lobe of Bahaja’s liver, weighing 400 grams, and the left lobe of Sarah’s liver that weighed 240 grams, and implanted both in the recipient. “There was a lot of pressure on our team as two donors were involved in the process. The patient’s transplant was already a high-risk one due to his multiple problems. But we succeeded in giving the patient a new lease of life,” Dr Goyal said. The life-saving transplant was performed on May 23rd 2019. Both the donors – Bahaja and Sarah are normal and healthy. The recipient, Mr. Al Naqeeb, was discharged with a healthy liver. Dual lobe liver transplants are rare because they are complex. In a single donor transplant, the venous channel in only side of the liver has to be connected in the recipient. But in a dual lobe transplant, venous channels of both the right lobe and the left lobe have to be joined, the doctor explained.

Nirali Memorial Medical Trust (NMMT), established by Mr. A. M. Naik, Group Chairman, Larsen and Toubro, will set up a multispeciality hospital at Navsari in Gujarat. The multispeciality hospital will be operated and managed by Apollo Hospitals Group. The agreement to this effect was signed by Mr. Naik and Dr Prathap C Reddy, Chairman, Apollo Hospitals Group. Named in the memory of Nirali, granddaughter of Mr. Naik who passed away due to cancer at the age of two. NMMT was set up by Mr. Naik and family to help needy patients without access to quality medical treatment. NMMT, a public charitable trust founded by Mr. Naik to carry out philanthropic activities in medical care, possesses the land parcel for this multispeciality hospitals. NMMT will build the infrastructure, install the medical equipment and appoint qualified doctors and paramedical staff to run the hospital. Apollo Hospitals Group will offer their medical expertise and facilitate operations and maintenance of the hospital. On the occasion, Mr. A. M. Naik said, “We owe a lot to the society we live in and are indebted to give it back to the people. It is endeavour of Nirali Memorial Medical Trust to provide best-in-class secondary and tertiary medical care facilities to rural and underprivileged social groups. The setting up of multispeciality hospital is a momentous step in the direction of extending affordable healthcare to all. We are delighted to have reputed healthcare group Apollo Hospitals joining this mission at Navsari in South Gujarat.” Dr Reddy said, “Since our inception thirty-five years ago, the resolute mission of Apollo Hospitals has been to make an international standard of healthcare accessible to every individual. Since then, every endeavour that we have undertaken has been a focussed step towards fulfilling our mission. Apollo Hospitals is honoured to support Mr. Naik’s noble efforts in setting up a multispeciality hospital in Navsari, which will offer succour to the people in the region by facilitating early detection of disease and timely intervention, thereby saving precious lives.” NMMT has developed ‘A. M. Naik Healthcare Complex’ at Sisodra (Ganesh) in Navsari. The complex spread over 9 acres houses an under-construction Cancer Hospital, will have a Multispeciality hospital and other medical care facilities. The under-construction cancer hospital at the complex will be operated and managed by Tata Trust. Mr. Naik has been instrumental in getting the best-in-class health facilities in the rural hinterlands of South Gujarat. NMMT runs the ‘Nirali Memorial Radiation Centre in Surat, Multidisciplinary hospital at Powai and provides modern medical facilities at a hospital in Kharel in South Gujarat. Along with NMMT, Mr. Naik has also founded the Naik Charitable Trust (NCT), which is focused on providing quality education and vocational training to the underprivileged sections of the society. Mr. A. M. Naik is a recipient of Padma Vibhushan and is also Chairman of National Skill Development Corporation.

In an extremely rare case of Budd Chiari Syndrome with Biliary Atresia, doctors at Indraprastha Apollo Hospitals, Delhi saved the life of a 5-month-old baby girl Surampudi Sehitha from Kakinada, Andhra Pradesh. The baby developed jaundice when she was just one month old. Her condition worsened as her abdomen started distending due to progressive swelling. Dr Anupam Sibal, Group Medical Director and Senior Pediatric Gastroenterologist and Hepatologist, Apollo Hospitals Group said, “In Biliary Atresia, which is seen 1 in 12000 babies there is no connection between the liver and the intestine. The first step in treatment is to create a connection between the liver and the intestine. This was attempted at the local hospital initially to treat the baby’s condition but as Baby Surampudi’s liver was already severely shrunken (due to cirrhosis), the procedure was abandoned. She was further referred to Apollo Hospitals, Delhi for a liver transplant.” “She weighed 5.5 kg when she first came to our hospital, including abdominal fluid of about 1 litre. So effectively, her weight was 4.5 kg. CT Angiography showed that she was suffering from occluded hepatic venous channels which drain the liver. The diagnosis of Budd Chiari Syndrome was made. It is a very rare disease which afflicts 1 in 2 million children. Budd Chiari Syndrome had resulted in rapid worsening of the baby’s condition which necessitated an urgent liver transplant. While Biliary Atresia is the most common condition for which liver transplantation in children are performed, Budd Chiari syndrome is extremely rare. Of the 320 liver transplants that we have performed in children, more than 140 have been for children with Biliary Atresia. The combination of Budd Chiari syndrome with Biliary Atresia in a baby is the rarest of rare case” Dr Sibal added. Baby Surampudi underwent a living donor liver transplant on 25th March, 2019 with her mother being her donor. Dr Neerav Goyal, Senior Consultant liver transplant and Hepatobiliary and Pancreatic surgeon, Apollo Hospitals Group, explained, “A combination of Budd Chiari and Biliary Atresia made the liver transplant very high risk. The blood vessels in a baby are very small (3-4 mm) and with Budd Chiari Syndrome the risk of clotting in the blood vessels is increased. We explained the procedure to the parents in detail and counselled them so that they make an informed decision. Initially, the father was worked up as the donor but his liver was found unsuitable for donation. The mother’s liver turned out to be compatible. After her surgery, Baby Surampada, recovered well and was discharged after three weeks. Today, she is on medications to prevent re-occlusion of her tiny vessels and to prevent rejection of the transplanted liver.” “As the family had limited resources, they received financial help from many benevolent people who came forward to contribute for her treatment through a crowd-funding platform” he added. The parents of the child said, “Having to watch our newly born in so much pain and is one of the toughest burdens that we had to bear as parents. However, doctors at Apollo Hospitals did not let our confidence shatter and worked dedicatedly to save the life of our baby girl. We are extremely thankful to the team of doctors at Apollo Hospitals as well as the people who came forward to help us out financially through this tough time. Our baby is alive and well, thanks to the kindness of many strangers.” The team included, Dr. Shishir Parikh, Liver Transplant and Pancreatic surgeon, Dr. V Arun Kumar, Liver Transplant and Pancreatic surgeon, Dr. Hitender Garg, Gastroenterologist and Hepatologist, Dr Namit Jerath, Pediatric Intensivist and Dr. Smita Malhotra, Pediatric Gastroenterologist and Hepatologist.

Apollo Hospitals introduces the first of its kind Digital PET CT – Biograph Vision 600™ scanning machine. The state-of-the-art scanning machine is a radioactive diagnostic agent used in positron emission tomography (PET) imaging. The inauguration was done in the presence of Dr. Prathap C Reddy, Founder and Chairman – Apollo Hospitals, Ms. Suneeta Reddy, Managing Director, Apollo Hospitals Group and Mr. Vivek Kanade, Executive Director, Siemens Healthineers India. Know more about Digital PET CT – Biograph Vision 600™

Apollo Proton Cancer Center, Chennai brings the best and latest medical technology in India, by successfully performing India’s first Total Marrow Irradiation (TMI) as a conditioning protocol prior to Bone Marrow Transplant on a 35-year-old female patient from Oman. Read more about India’s first Total Marrow Irradiation (TMI)

Apollo Hospitals, Guwahati was the first hospital in Guwahati to perform Minimally Invasive Cardiac Surgery on March 7, 2019. A team of experts headed by renowned Cardio Thoracic Surgeon Dr. J P Kalita performed the complex surgery and saved a patient’s life. The surgery was performed on a 45-year-old female patient who had a hole in her heart and leakage of a heart valve. Patient underwent a successful key hole surgery through chest wall rather than the conventional breast bone cutting open heart surgery. The main benefit of this surgery is minimal post-operative recovery time, less pain and minimal blood loss. Moreover, the chance of getting infected after the procedure is also comparatively very less. Any patient who undergoes minimally invasive cardiac surgery can resume their normal activities within two weeks. Patient recuperated well after the surgery and got discharged. The Cardiac surgery team at Apollo Hospitals Guwahati is headed by Dr. J P Kalita. Dr. Kalita is an expert in Minimally Invasive Cardiac Surgery for both Adult and Paediatrics. At the advent of this new Cardiothoracic unit in Apollo Hospitals Guwahati, people of Assam and neighbouring states will also be highly benefitted.

Mr. Desai, a 41-year-old male, met with a road accident that resulted in a traumatic brain injury and was promptly taken to Apollo Hospitals, Navi Mumbai on September 15, 2018. When bought in, he was unconscious, with evident CSF rhinorrhoea and otorrhoea from left ear, and herniating brain tissue from the left nostril. Once the patient was stabilized, he was taken for an urgent Craniotomy for evacuation of subdural Hematoma, intra-cerebral contusion, and repairing of the skull base. He was then moved to the ICU for recovery, which in view of the severe brain injury was slow. On October 29, 2018, he was finally discharged as his sensorium had improved. The patient’s brain was allowed to heal for several months before the planned Cranioplasty. The team of doctors at Apollo Hospitals, Navi Mumbai, had to ensure the best possible cosmesis without major intraoperative manipulation of the skull base repair. The defect also covered a large part of the forehead extending to the bridge of the nose and the left supraorbital ridge – all of which had cosmetic implications. Hence, 3D-printed titanium implant was opted because it would closely replicate the shape of the patient’s skull. On January 9, 2019, the patient underwent Cranioplasty with the implant, after which he made a swift recovery and was discharged three days later. 3D-printed implants are beneficial for multiple reasons like it fits the patient’s form, MRI compatible and lesser chances of getting infection. In this case, first a CT scan helped make an identical 3D model of the skull in its current form. Then a titanium mesh was created to perfectly fit the skull. Once it was ensured that the implant was a perfect match for the patients’ structure, the neurosurgeons went ahead with the Cranioplasty. Dr Sunil Kutty, Consultant, Neurosurgery, Apollo Hospitals, Navi Mumbai said, “It was a bad case of head injury and not many survive these kinds of injuries. His recovery was a team effort and we also had a challenge in the form of making his face and head look as normal as possible. After being admitted on September 15, 2018, Mr. Desai was in the hospital for about a month and half, before being discharged. After allowing the brain of patient to heal for several months, Cranioplasty (surgical repair of a defect or deformity of a skull) was undertaken. The team needed to ensure the best possible cosmesis without major manipulation of the skull base. A large part of the forehead extending to the bridge of the nose and part of the ridge was affected and had cosmetic implications. Therefore, we decided that a 3D printed titanium implant would be suitable to closely replicate the shape of the patient’s skull. On January 9, 2019, the patient was bought in for the Cranioplasty with the implant and was discharged three days later. 3D printed implants are MRI compatible, decrease the risk of infections and most importantly can be made to fit the patient’s form. Mr. Desai may take a couple of years for complete recovery, but he will soon get back to being a constructive part of the society.”

At the tender age of six months, Emmanuel Lila Kamank, a Kenyan national, underwent open-heart surgery for a rare cyanotic congenital heart defect known as Taussig-Bing anomaly at Indraprastha Apollo Hospitals. Just four days after his birth, Emmanuel was diagnosed with this heart defect and as his condition worsened, he was referred to Apollo Hospitals, Delhi for surgery. Dr. Muthu Jothi, Senior Consultant- Paediatric Cardiothoracic surgeon, Indraprastha Apollo Hospitals, New Delhi explains, “When Emmanuel came to Apollo, he was already cyanotic, which means that he had bluish discoloration of skin due to lack of oxygen in his blood. On examination, it was found that his respiratory rate was below normal at 20 breaths per minute. At the hospital, he suddenly underwent respiratory arrest. The attack was so severe that the child also had a cardiac arrest. His condition was pretty dire due to which he was put on ventilator and shifted to cardiac ICU.” Dr. Jothi further stressed on the criticality of the baby’s condition, “The child was already diagnosed with Taussig-Bing anomaly, which is a malformation of the heart in which there is transposition of aorta to the right ventricle, which in normal cases should originate from left ventricle. At the same time, his pulmonary artery was also wrongly positioned into the right ventricle. This is called double outlet right ventricle defect. Upon further investigation, we found out that there was also an interrupted aortic arch (block in the aorta). On top of that, the child had large subpulmonary ventricular septal defect (VSD), atrial septal defect (ASD), and Patent ductus arteriosus (PDA), wherein ductus arteriosus, the blood vessel that is open when the child is inside the mother’s womb does not close due to this defect. In addition to all this, he also had a single coronary origin giving rise to right and left coronary arteries. The right coronary had a part inside the wall of the aorta which we call as intramural coronary artery. This makes it very difficult technically to relocate the coronary arteries into the new aorta. Needless to say, it was very high risk case with limited chances of success even with surgery. We devised a treatment plan for the baby, but informed his family about the 50-60% surgical risk associated with it. The family consented to the high risk and we decided to go ahead with the procedure.” On 21st January 2019, the child underwent the surgery which was performed by Dr. Muthu Jothi and his team consisting of Dr. Manisha Chakrabarti, Senior Consultant Paediatric Cardiologist and Dr. Reetesh Gupta, Senior Consultant Paediatric intensivist. Explaining the complexity of the surgery, Dr. Muthu Jothi said, “The procedure was done under total circulatory arrest, which means that the entire blood in circulation in his body was drained into the heart lung machine. Before that we had to cool the child’s body to 16 degrees Celsius. This is near freezing for the human body. We even put ice on the surface of his brain. Without circulation, we can keep the patient in this state for maximum of 45 minutes. Beyond that, there’s the risk of injury to the brain, spinal cord, kidneys and other organs. The total time Emmanuel was on total circulatory arrest was 30 minutes. During this time, we repaired the aortic arch interruption by tying off and disconnecting the PDA blood vessel and connecting it to the aortic arch. After doing this, we put the child again on the heart-lung machine and did the switch operation to put the blood vessels in their correct position. The intramural coronary artery was a very difficult condition where we had to mobilise this blood vessel and re-implant it into the new aorta. During this process if there’s an error of even half a millimeter, if it doesn’t go exactly where it needs to go, the coronary artery’s blood supply will be reduced, which can cause a heart attack. This repair was followed by closure of ventricular septal defect (VSD) and atrial septal defect (ASD). It was a very long surgery lasting almost 9 hours.” The operation was successful and the baby was shifted to the ICU in a stable condition but with his chest still open, “The chest was kept open for 24 hours because there was a lot of swelling in the heart once we did the operation. Once the swelling came down and the child started passing urine post 12 hours after the operation, we closed the chest in the ICU. After this, child stayed for nearly a week on the ventilator,” Dr Muthu explained. Baby Emmanuel slowly recovered and was discharged on the 17th day from the hospital. The parents of the baby expressed their gratitude to the team at Apollo Hospitals who successfully operated on baby Emmanuel and treated him, “By the grace of God and the tireless efforts of Dr. Muthu Jothi and his team, Emmanuel is now well and has a long life ahead of him. Our prayers have been answered at Apollo Hospital and we cannot thank the doctors enough for their dedication. They kept us motivated throughout the treatment process.” Baby Emmanuel has now gone back to Kenya with his family and is doing well.  

The doctors at Apollo Hospitals, Hyderabad have successfully performed Liver Transplant on a four-month-old baby. It was a challenging case for doctors to perform transplant surgery on such a small baby. There are only few hospitals worldwide, having the capability to perform liver transplants among children, weighing less than 5 kgs and below 6 months of age. At Apollo Hospitals, Hyderabad, the Pediatric Liver Transplant team has tremendous experience and expertise along with the technology to perform critical and delicate liver transplant surgeries in infants, said Dr Manish C Varma, Head of the Liver Transplant Department at Apollo Hospitals, Jubilee Hills. In Vizag, the treating doctors performed a Porto-enterostomy surgery on the baby, to treat pediatric liver disease, where the bile ducts are abnormally narrow, blocked, or absent. The baby was only 2.5 months old when he underwent this surgery. However, even after the surgery, there was no sign of jaundice subsiding and the condition was further deteriorating. The doctors at Vizag recommended liver transplant and the baby was brought to Apollo Hospitals, Jubilee Hills. On March 14, Liver Transplant surgery was performed and Mrs. Sarojini, mother of the baby, was the donor. Post-operatively the baby recovered well and was discharged nine days after surgery on March 23. The donor was discharged on March 19. “There is a need for spreading awareness that however small and underweight the baby is, it can be treated with a liver transplant if it is needed,” said Mr. Y Subramanyam, CEO Apollo Hospitals. The complicated liver transplant was carried out by a multidisciplinary team consisting of Dr Ramesh Srinivasan, Pediatric Hepatologist, Dr L Sasidhar Reddy, Transplant Surgeon, Dr Manjunath and Dr Vijay, Anesthetists and Intensivists respectively and Dr Samiya Razvi, Pediatric Pulmonologist, at Apollo Hospitals, Hyderabad.  

Apollo Gleneagles Hospitals brings TARE (Trans Arterial Radio Embolization), the latest treatment for liver cancers for the first time in Kolkata. It is the only option and hope for a special set of patients, who are actually quite large in number. TARE is a procedure, where using special instruments and micro-catheters, the identified source of blood supply to the tumor in liver is accessed and intra-arterial radiotherapy is delivered using Yttrium-90 (Radiotherapy agent). This results in significant improvement and at times complete treatment of the tumor as well, giving new lease of life to these patients. The TARE procedure requires special permission for the hospital to perform it with multiple other considerations. Mr Rana Dasgupta, CEO Apollo Gleneagles Hospitals Kolkata, expressed “We at Apollo Gleneagles Hospital are happy to announce that honouring our commitment to deliver the best healthcare and innovative procedures for our patients; we have started performing TARE, which would benefit our patients substantially. With this, Apollo Gleneagles Hospital, Kolkata becomes the first corporate multispecialty hospital in the East to perform this procedure.” Present at the occasion, Dr Manash Saha, Senior Consultant, Vascular & Non-Vascular Intervention, Apollo Gleneagles Hospitals Kolkata expressed, “The first TARE procedure performed in Apollo Gleneagles Hospital was for a patient of multiple colorectal metastasis which was progressive in nature and was not responding despite two separate lines of chemotherapy.” He also mentioned, “Primary liver cancers, particularly hepatocellular carcinoma (HCC) and extensive metastasis or secondary deposits in the liver pose a great clinical challenge to treat, especially if they are progressive in nature despite all kinds of treatment. With a huge and increasing burden of Hepatitis B and C patients, the HCCs are in rise. Hepatocellular carcinoma, however, poses a completely different degree of challenge to treat . Usually they are detected when quite big in size and not possible to treat by any other means. Many a times they are detected with the tumor thrombus progression in the main blood supply to the liver that is the portal vein, which makes them inoperable or untreatable. Even small lesions in the liver peripherally can present with the malignant portal vein thrombosis rendering these patients untreatable even if they are completely preserved functionally in presentation. TARE procedure is considered as the pinnacle of intervention and with this, AGHL is now equipped with the full set of interventional radiology treatments to patients of liver cancer whenever required. The entire range of treatment is now available under one roof in AGHL, Kolkata starting from ablative therapies like radiofrequency and microwave ablation to TACE (transarterial chemoembolization) – both conventional as well as DEB (drug-eluting bead) TACE along with TARE. The TARE procedure is done in two sittings where in the first sitting, the tumor is identified by angiographic evaluation and any potential source of extrahepatic organs are embolized to reduce the chances of radiotherapeutic agents going to other organs. Following this, the dose is calculated and prepared usually in Canada or Singapore from where the dose is transported in a premeasured amount and delivered on specific dates using a special system in the Cath lab.  

‘No matter how hard life is, don’t lose hope’ – The saying stands true for 45-year-old Etika Kalra, a resident of Delhi, who underwent a third kidney transplant at Indraprastha Apollo Hospitals. This time, her husband donated his kidney to save her life. Even though they were ABO incompatible, which means that their blood groups did not match, due to the skilled expertise of Padma Shri awardee Dr. (Prof) Sandeep Guleria, Senior Consultant, General Surgery, GI Surgery and transplantation, Indraprastha Apollo Hospitals and his team, the highly complicated transplant was performed successfully. Dr. Guleria performed the earlier kidney transplants as well. In 1996, when she was 23 years old and recently married, Ms. Kalra found out, during a routine check-up, her kidneys were shrinking. She was diagnosed with Glomerulonephritis, a type of disease in which the part of kidney which filters blood (called glomeruli) becomes damaged. Since that time, Ms. Kalra has been constantly fighting a battle with this disease. Initially, she explored various Ayurvedic treatments to treat her condition, but there was no relief and the creatinine levels in her blood continued to rise. In December 2000, she had to start regular dialysis as her kidneys were no longer functioning properly. Ms. Kalra underwent her first kidney transplant in 2001 where her elder sister Anshoo Walia donated her kidney. For more than a decade the donated kidney served Ms. Kalra well, but the life of a donated organ is limited. By 2014, she again started facing kidney problems. “By the time we found out that her first kidney was failing, it was too late to start her on dialysis. Her health was deteriorating fast and so we opted for a pre-emptive transplant. This time, her other sister, Ritu Pahwa, donated a kidney,” Dr. Guleria said, explaining the procedure and the unexpected complications which arose after. “A few days after her second transplant, while Ms. Kalra was still in ICU, she started complaining of severe stomach pain. It was found that she had gangrene of intestine for which we had to do an immediate major abdominal surgery to save her life. This was while she was still recovering from her second kidney transplant and it made her quite weak.” Unfortunately, the second kidney was functional only for about 4 years after which it started failing. “It was a case of acute antibody rejection of the transplanted organ, in which Ms. Kalra’s own immune system started attacking the kidney. There were only two viable options for her at that time – either live on dialysis for the rest of her life or undergo another kidney transplant. Ms. Kalra chose the latter and this time her husband, Tarun came forward to donate his kidney. We counselled the family about the various risks involved with this surgery, after which they gave us consent to go ahead. Their blood groups did not match so to overcome the ABO incompatibility; we did numerous plasma exchanges. The first two transplants took about three hours but the third transplant took five and a half hours since the third operation was technically more difficult. However, we successfully overcame that barrier and transplanted the third kidney.” In regards to Ms. Kalra’s incredible story, Dr. Guleria said, “Etika’s body is responding well to the new kidney and we hope that this time it will last for the rest of her life. Surviving three kidney transplants takes an incredible amount of strength, endurance and faith. She did not lose hope and her strong will to live pushed her to not give up at any point. Her family support was unwavering throughout.” Ms. Kalra is now doing well and wants that her story motivates others to not give up in the face of adversity, “When the option of kidney transplant for the third time was presented to us, it came as a surprise. For a layman, two kidney transplants are rare. But Dr. Guleria explained that kidney transplant is possible even for the third time and one can lead a normal life after that. He apprised us of all the possible complications. But since he had already performed the kidney transplants twice on me before, I had full faith in him and knew that my life was in the hands of an experienced and trusted doctor. After all these years, Dr. Guleria is like family to us now, and his guidance and support has been invaluable. My children are the source of my inspiration who keep me going,” said Ms. Kalra. “Even after the third transplant, the precautions I have to take are the same as before. The food I eat has to be hygienic and freshly prepared. Eating outside should be avoided, and it is essential to have medicine on time,” Ms. Kalra said.