Apollo Proton Cancer Centre has launched a dedicated Robot-Assisted Cancer Surgery Unit so that it could offer all its patients comprehensive cancer care under one roof. Apollo Proton Cancer Centre also successfully performed its first robotic procedure on a 40-year-old patient. The Robot-Assisted Cancer Surgery unit is equipped with the advanced fourth-generation ‘Da Vinci Surgical System’ and a dedicated team, led by Dr. Ajit Pai, Senior Consultant and Lead surgeon, GI Oncology. Read more about the Robot-Assisted Cancer Surgery Unit launched in Apollo Proton Cancer Centre

On the occasion of World Health Day, the Apollo Hospitals Group unveiled a report on the Health of the Nation that puts a spotlight on how the last two decades have seen a steady rise in non-communicable diseases (NCDs). The contribution of NCDs as the top causes of death in India has risen to a staggering 64.9% as compared to communicable diseases, maternal and other causes that dropped to 25%. The study provides a unique perspective drawn from Apollo Hospitals’ 37 years of experience and its vast footprint across the country and underlines how Artificial Intelligence and Big data analytics can help to predict risk and prevent NCDs. Given the pandemic, this is also important as individuals with NCDs such as diabetes, heart disease, hypertension, chronic kidney disease, and chronic liver disease have a greater mortality risk from COVID-19. Dr Prathap C Reddy, Founder and Chairman, Apollo Hospitals Group said, “Even before the pandemic began, we have been facing an unacceptable loss of lives due to non-communicable diseases (NCDs). The silent epidemic of NCDs was evident with NCDs behind 40% of all hospital stays. However, in dealing with the COVID-19 pandemic, the data from our Health of the Nation report made it clear that we have let another epidemic slip, the epidemic of NCDs – the impact of which we are already beginning to see around us. We can overcome NCDs together as a country, only if each and every one of us take our health seriously. “At Apollo, we have been working on preventive health for over 37 years. From the very first Master Health Check in the country, we have been constantly evolving our programs for early detection and better clinical outcomes. Apollo ProHealth is a proactive personalized health management program backed by cutting-edge technology – advanced diagnostics, artificial intelligence and predictive algorithms – to help identify your health risk. It coaches you to stay on the path to wellness until your health goals are achieved. With Apollo ProHealth, we hope to change the health check paradigm from a long checklist of tests to a meaningful conversation with the doctor on the status of your health, with a comprehensive plan to make you healthier tomorrow than you are today. Today, on World Health Day, on behalf of the Apollo Hospitals Group, I dedicate Apollo ProHealth to the health of our nation!” NCDs affect not just health, but also productivity and economic growth. The 2030 Agenda for Sustainable Development adopted by the United Nations recognises NCDs as a major challenge for sustainable development with the target to reduce premature mortality from NCDs by one-third by 2030. The pandemic last year has exacerbated the risks and impact of NCDs manifold, as also shown in the Health of the Nation report. Dr Sangita Reddy, Joint Managing Director, Apollo Hospitals Group said, “Apollo Hospitals’ commitment is to the health of the nation, with a vision to make our nation healthier. With the urgent need to respond to the challenge of non-communicable diseases, we cannot afford a pure treatment and curative approach to health. We believe that a focus on prevention will be transformative for the health of the nation. We are harnessing the power of technology to develop new methodologies for screening, detection, and patient risk profiling. We are using our pioneering experience of over 37 years and countrywide network to create and innovate new models of care to improve clinical outcomes. We have been the first to adopt Artificial Intelligence and Big data analytics to predict risk and personalize care. “Today, we are showcasing our insights into a vast amount of health data that will form the foundation of a healthcare model for our future. Many arms of Apollo Hospitals have worked together, collating their knowledge, data on the incidence of disease, and put that into one holistic report that is a representative study of the Health of the Nation.” NCDs account for 65% of all deaths in India. There is a need to look at new norms of preventive health management that allow us to detect and tackle risks from NCDs before they manifest, even more so in the context of the COVID-19 pandemic. The Health of the Nation report offers a unique perspective of the healthy and unhealthy – across occupations, economic segments, and demographics, and trends of non-communicable diseases across the country. The study will help put in place approaches to improve disease prevention, increase the accuracy of early diagnoses that will, in turn, lead to a more personalized and patient-centric treatment approach. Dr Anupam Sibal, Group Medical Director, Apollo Hospitals Group said, “The Health of the Nation study highlights the need to direct our efforts efficiently towards controlling NCDs through optimal use of our healthcare infrastructure. The highest prevalence of pre-diabetes and diabetes is seen in 45-60 year olds and is almost as high as the 60+ age group. Amongst the diabetics, around 50% also have hypertension and are above the recommended weight. Around 60% of these diabetics are also leading a sedentary lifestyle. The data also indicates that while women have lower incidence of NCDs, the difference is marginal. Hence, they must stay vigilant. The economically disadvantaged are also not spared, although with lower prevalence.” There is a significant diabetes population in the major metros and suburbs of India, especially the Delhi NCR – Punjab & Haryana Belt, Kolkata, entire Mumbai-Ahmedabad belt, Hyderabad and Chennai, Kerala and Tamil Nadu, as well as in the predominantly rural areas of MP, Maharashtra, UP, Bihar, parts of Orissa and Gujarat. There is a significant hypertensive population in major metros such as Delhi, Punjab & Haryana, Kolkata, Mumbai, Goa, Trivandrum and Hyderabad and in the predominantly rural areas in Tamil Nadu, Karnataka, UP, Bihar, Orissa and Gujarat. Prof. Nirmal Kumar Ganguly. Former Director-General, Indian Council of Medical Research and President, Apollo Hospitals Educational and Research Foundation said, “Our pilot community health model, Total Health, to reduce premature NCD-related deaths in rural areas was launched in 2013 in Aragonda, Chittoor district. The program saw 31,350 people classified as low risk, moderate risk and high risk, according to their ten-year risk of developing NCDs, and proactively managed with regular follow up, investigations, medication, clinical interventions, counselling and lifestyle modifications for diabetes, hypertension and cancer. In addition, the program also addresses all other social determinants of health in the country (e.g., drinking water, nutrition, kitchen gardening, livelihood generation) to beyond just health to ‘Total Care’ for ‘Total Health’. Around 80% of mortality from NCDs is preventable with early detection and proper management. It is critical to continue to focus on regular health check-ups to detect NCDs along with AI-enabled tools that allow premature health events to be identified early. Under this program 1,980 diabetic and hypertensive patients have been put under regular follow up, who are under now control with proper investigations, medication, counseling and life style modifications. Also 5,391 rural women were screened for cancer and 17 early cancer cases (cervix and breast) were diagnosed and managed with appropriate health intervention services which were free of cost Dr Sujoy Kar, Chief Medical Information Officer said, “The study gives us the data that will allow the effective use of technology to predict risks and guide our actions to prevent and rein in the NCD epidemic. One such example is to evaluate and manage the High Sensitive Troponin-I (hsTnI)categorical CVD risk in subjects undergoing preventive health checks (PHC). “AI and predictive algorithms can predict risk, prevent premature health events, and overcome chronic lifestyle diseases, when caught early. For example, we have developed a Cardiovascular Risk Score (AICVD) in the Indian population and it is now prospectively used and followed up on 33000 individuals as part of ProHealth to predict the risk of developing cardiovascular disease. There are various clinical tools using AI and data analytics ready for deployment as well as under research for various NCDs. These include tools and algorithms to identify medical issues early in CT scans, predict various risks including the risk of developing cardiovascular disease, asthma, liver fibrosis in NAFLD, breast cancer, pre-diabetes and stroke. Dr Sathya Sriram, CEO, Preventive Health, Apollo Hospitals Chennai said, “The Health of the Nation study has shown us the importance of shifting the paradigm in India from a curative to a preventive mindset. Apollo ProHealth, empowered by AI and predictive algorithms, is a personalized proactive health management program based on 22 million health checks, building on Apollo’s pioneering efforts in preventive care and led by medical experts committed to making individuals healthier. Apollo ProHealth includes personalized health risk assessment to predict health risks and diagnostics tailored to your profile, physician-led evaluation for a personalized treatment plan and wellness goals, and Health Mentors to regularly monitor your health parameters and help individuals stay on the path to wellness. Over the last 12 months, a cohort of ProHealth guests with diabetes have shown 33%-60% target achievement across multiple health parameters, such as blood pressure, cholesterol, physical activity and HbA1c. The Health of the Nation report is the basis on which NCDs can be managed proactively, with the data used for early identification and management of NCDs using AI and data analytics to enable India to follow an accelerated path to meet SDG goals by 2030.

Apollomedics Super Specialty Hospital, Lucknow is the first private hospital in the state (excluding NCR region) to perform successful liver transplant surgery. Honorable Chief Minister of the State Shri. Yogi Adityanath inaugurated the Apollomedics Liver Transplant Program. Now, Liver transplant patients will have access to an advanced Liver transplant facility in Lucknow itself, for which previously, people had to travel to other states. Along with this, Apollomedics Super Specialty Hospital, Lucknow has already performed more than 50 Kidney Transplants successfully and will soon provide the facility of complex organ transplants such as Heart, Lung, Bone Marrow, Cornea, etc. also in Lucknow. Inaugurating this program, the Chief Guest and Hon’ble Chief Minister of the State, Shri. Yogi Adityanath said, “I want to congratulate Apollomedics Super Specialty Hospital, Lucknow for performing the first successful liver transplant surgery. This is a commendable step towards establishment of a robust healthcare model in Uttar Pradesh. Now people of the state will get the benefit of complex surgeries like Liver and Kidney transplant in UP itself. The state government is continuously making efforts to provide advanced medical services to the people of the state with the help of Government and private health institutions. We hope, that with this initiative of Apollomedics, Uttar Pradesh will become the flag bearer of Transplant services in the country.” During a recent address, Honorable Prime Minister Shri Narendra Modi Ji gave mantra of making India “Aatm Nirbhar” (self-reliant) in the field of healthcare, by working on the basis of PPP model. This achievement by Apollomedics Super Specialty Hospital, Lucknow is a crucial step in this direction. Dr. Mayank Somani (MD & CEO Apollomedics Super Specialty Hospital, Lucknow), congratulated the entire team involved in the transplant surgery and said, “the Apollo Organ Transplant Program is India’s largest and most comprehensive transplant program.” With the introduction of this program, Apollomedics Super Specialty Hospital, Lucknow will now be able to provide international standard treatment to patients suffering from end stage Liver and Kidney diseases. Along with this we are working on providing services of Heart, Lung, Bone Marrow and Cornea transplant which will soon be made available to the residents of the state. Giving information about the special liver clinic started for liver patients, Dr. Somani said, “Along with this, every Thursday we have started a special liver clinic, where the specialists in our liver facility will provide counseling to the people suffering from liver diseases.” Dr Prathap C Reddy, Founder-Chairman, Apollo Hospitals said “Its indeed a proud moment for all of us that Apollomedics Super Specialty Hospital, Lucknow is achieving milestones one after another in such a short span of time. Starting with the first successful Pediatric Liver transplant in India in 1998 with Sanjay who was then 20-month-old, many landmarks have been established. Sanjay is now a doctor and not just patients from different states of India but those from 50 countries have received liver transplants at Apollo. More than 3600 liver transplants have been performed of which 397 are on children. Apollo hospitals is committed to delivering global standard of Solid organ transplant services in Uttar Pradesh”. The liver transplant team of Apollomedics Super Specialty Hospital, Lucknow explained, “54-year-old patient, a resident of Tanda was suffering from Liver Cirrhosis for the past two years. He was brought to our hospital in a very critical condition. After all the necessary investigations, it was diagnosed that liver transplant is the only viable option left for saving the life of the patient. The son of the patient agreed to donate part of his liver. The team of 6 surgeons took about 15 hours to complete this complex surgery. Both recipient and donor are healthy post-surgery and have been discharged from the hospital without any complication. The team included Dr Neerav Goyal (HPB Surgery & Liver Transplant) & Dr Ashish Mishra (HPB Surgery & Liver Transplant) along with Dr. Waliullah (Surgical Gastroenterology), Dr. Suhang Verma (Hepatology), Dr. Rajeev Ranjan (Hepatology), Dr. Manish (Anesthesia) Dr. Shishir (Anaesthesia), Dr. Anshuman (Anaesthesia) and Dr. Ajay Kumar (Chief Consultant – Critical Care and Director Medical Services).

Apollo Hospitals, Navi Mumbai, has successfully performed four liver transplants following COVID-19 recovery. The four patients were diagnosed with end stage liver disease, following which 3 patients underwent living donor liver transplant and 1 deceased donor liver transplant. Post the liver transplant all the patients have recovered and are doing well. Patient Tanvi Palande, a 19 -year-old liver transplant survivor, said, “With my deteriorating health condition, lockdown and pandemic, it was a challenging situation for my family. We had to be strong as we took up the decision to go ahead with a liver transplantation surgery. However, following our decision, my family was diagnosed with COVID-19. So, when I read that my test results were also positive, it instilled a sense of fear in me. It was the first time that I was really scared. The doctors gave me a lot of support and counselled us which gave us the confidence to go ahead with the liver transplant. I am ever thankful to my mother, who had donated a part of her liver, to save me and the doctors for all the support and for giving me a new lease on life.” One of the patients, a 37-year-old, suffered from a case of chronic liver disease that persisted for 8 months. Recurrent encephalopathy, ascites and vomiting of blood due to a deteriorated liver was noted as an immediate liver transplant was suggested. Subsequently, he also suffered from COVID-19, making the case more challenging. Taking on the case with proper protocols as introduced during the COVID-19 pandemic, the liver transplant team at Apollo Hospitals Navi Mumbai, successfully performed the surgery. Another 36-year-old patient suffering from ethanol related decompensated chronic liver disease also approached Apollo Hospitals with persistent fever and myalgia. He tested positive for SARS-CoV-2. Following recovery from COVID-19, all the necessary steps were taken to prepare him for a liver transplantation surgery. Owing to the seriousness of the case, many complications such as unsuitable donor for living-related donor liver transplant did arise. However, essential evaluation of the organ donor’s liver, including RT-PCR tests were conducted twice before the surgery took place. The liver transplantation was a success and the patient is in good health now. Similarly, the other cases have also been treated successfully. Dr Aabha Nagral, Consultant, Hepatology (Adult & Paediatrics), Apollo Hospitals Navi Mumbai, “Liver transplantation on COVID-19 patients poses major challenges not only to the patient and the family, but to entire systems and medical teams in the hospital. Treating patients with liver conditions following a recovery from COVID-19 comes with tremendous challenges, as the patients are more prone to infections. Despite the emergency situation, we made all the efforts to continue with liver transplant activity, minimizing the waiting time and mortality. Despite facing concerns, by taking all the precautions and protocols, we proceeded with lifesaving treatment and successfully conducted liver transplantations on four patients who recovered from COVID-19. Talking about the same, Dr. Vikram Raut, Consultant, HPB & Liver Transplant Surgery, Apollo Hospitals Navi Mumbai, said, “It has been challenging to work on the four patients with liver conditions. The four cases we received came with many complications, including being COVID-19 positive. However, by following the mandatory precautions of COVID-19 and post the negative reports of COVID-19 tests, we performed the liver transplantation for all the patients. One of the patients had to receive a donor from a deceased person, making it first post-COVID-19 DDLT (Deceased Donor Liver Transplant) in Western India. Taking prudent intra and post-operative precautions to prevent possible transmission from health-care personnel, ensuring adequate availability of blood products, drugs, supplies and infrastructure, strict postoperative infection control measures and quarantine protocols and judicious management of immunosuppression post-operatively, formed the cornerstones for ensuring a successful liver transplantation surgery during the peak of the pandemic.” He further adds, “Risk of mortality due to decompensated liver disease is 30 -50% vs risk of mortality due to COVID-19. COVID-19 infection aggravates acute decompensation in cirrhosis patients which increases risk of mortality.” Mr. Santosh Marathe, Unit Head & COO, Apollo Hospitals Navi Mumbai commented “Over the years our institution has treated and performed numerous transplant cases. This year has been challenging with the rising cases of COVID-19 in Maharashtra and patients facing related comorbidities of chronic liver diseases. Following all the international safety control protocols, we continued with the transplant programme, as most the patients were in end stage organ failure. In the last 14 months, we have successfully performed 29 liver transplants, 42 kidney transplants and 2 heart transplant with excellent clinical outcomes, ensuring quality of life. Also, we have created accessibility of liver transplant services through speciality clinics for screening and evaluation in different districts of Maharashtra and partnered with different institutions to perform liver transplant surgeries.

A 46-year-old resident of Navi Mumbai, Mr. Rajesh, successfully underwent a heart transplant surgery at Apollo Hospitals, Navi Mumbai. He received the heart from a 52-year-old woman, a deceased donor. The patient, with severe heart failure, had been on the heart transplant waiting list for six months and was admitted around eight times with intractable heart failure during this period. While his life was saved each time, a heart transplant was the only hope and with no organ available in Mumbai, he decided to go to Chennai for a heart transplant. The transplant surgery was successfully completed in four hours, with the patient off the ventilator within 24 hours. Dr Sanjeev Jadhav, Heart & Lung Transplant Surgeon, at Apollo Hospitals, Navi Mumbai said, “When the patient, Mr. Rajesh came to Apollo Hospitals, he had been suffering from a dilated heart (dilated cardiomyopathy) functioning at only 20% ejection fraction since the last five to six years. That meant his heart was pumping only one-fifth of the blood out of the left ventricle (the main pumping chamber) every time it beat. Anything less than 35% poses a high risk of developing a dangerous arrhythmia and going into heart failure. An automated cardioverter defibrillator pacemaker had been implanted to give an electrical stimulus to the heart and bring it back to normal rhythm in case of any change. He also had a history of severe cardiac failure with lung infection and fluid collection in the lung lining (pleural effusion) last year and was suspected to have contracted COVID-19 infection.” When the patient came to Dr. Jadhav at Apollo Hospitals, Navi Mumbai, he was treated for his heart failure and after evaluation, he was put on a heart transplant waiting list. Dr. Jadhav added, “However, he did not get a matching heart for six months, during which time he was admitted multiple times with intractable heart failure. We saved him each time, but with time running out, the patient decided to go to Chennai for the transplant. Even in Chennai, there was no matching organ available for four weeks and just when he was losing hope, a donor heart became available in Mumbai. He was informed and he flew back immediately for the transplant surgery. The organ matched and we performed transplant surgery that took around four hours. It was a complete success. He was taken off the ventilator and was able to breathe on his own within 24 hours.” Mr. Rajesh, the patient was grateful for the organ and the donor’s family. On his new lease on life, he said, “I had almost lost hope before coming to Apollo Hospitals. The doctors and the team here gave me hope and saved my life multiple times when I went into heart failure. The positive attitude of Dr Sanjeev Jadhav and the entire team as they stood like a pillar for me, kept me going through my treatment and the long wait for the donor organ. I am thankful to the hospital, the doctors and the donor’s family for giving me a new lease of life. I look forward to returning to my family and normal life soon.” Mr. Santosh Marathe, COO & Unit Head, Apollo Hospitals, Navi Mumbai, said, “The case highlights how organ donation can save lives and at Apollo Hospitals, our endeavour is to promote and spread awareness about the need for organ donation. Through organ donation, one can serve society even after death. Apollo Hospitals, Navi Mumbai is recognised as one of the most advanced transplant centres in Western India with successful liver, kidney, heart and bone marrow transplants recorded. The unit has also handled multiple international transplant cases and undertaken liver transplants at other affiliated hospitals in Maharashtra. The Apollo Hospitals’ organ transplant team is known for some of the finest transplant surgeons in the country with years of experience who are backed by specialists and a support staff that includes Transplant Coordinators, Social Workers, Psychiatrists and Anaesthesiologists.”

Apollo Hospitals Group has notched up yet another milestone with the successful completion of four back-to-back MitraClip procedures in one single day. The MitraClip implants were carried out on four patients suffering from severe heart failure, surpassing Japan where MitraClip procedures were performed on three patients in a single day. The four back-to-back MitraClip procedures were performed at Apollo Hospitals, Chennai by Dr Sai Satish, Senior Interventional Cardiologist. The minimally invasive method used in MitraClip therapy allows repair of a leaking mitral valve without open heart surgery, and is a lifesaver for patients at high surgical risk. All four patients, the oldest of whom was 87 years old, went home walking within 3 days and are currently doing well. Read more about four back-to-back MitraClip procedures performed at Apollo Hospitals, Chennai

Apollo Cancer Centres proudly launched the “The Power to fight Breast Cancer is in Your Hands” campaign, which illustrates the importance of regular self-breast examination and screening on this International Women’s Day. Ms Radikaa Sarathkumar presided over the campaign by launching the digital platform for breast self-examination along with Ms Preetha Reddy, Vice Chairperson, Apollo Hospitals Group. Read more about the Breast Cancer awareness campaign

Apollo Hospitals Group partners with Anatomiz3D Medtech Pvt Ltd. for design and printing of complex implants. Apollo Hospitals and Anatomiz3D would take the lead in a pioneering initiative to establish Hospital 3D-printing labs in India for 3D printed implants that would enable doctors to visualize and print implants for complicated cases. The first of these would be launched at Apollo Health City, Jubilee Hills, Hyderabad. Dr. Prathap C Reddy, Founder and Chairman, Apollo Hospitals Group said, “We are proud to once again be the pioneers in bringing the latest in medical technology to benefit our patients. It would not be wrong to say that with the Hospital 3D-printing labs, the future of healthcare is here! Personalisation of healthcare is the new mantra and advances in genomics and precision medicine are driving personalised prevention and treatment. From specialised medicines for targeted therapies to customised implants and prosthetics, 3D-printing technology is transforming the medical environment providing a fast, accurate and economical solution to take medical care to the next level. As healthcare evolves, 3D-printing will play an important part of this future transformation.” The Hospital 3D-printing labs would provide medical 3D printing services for better healthcare, through the creation of anatomical models for pre-surgical planning and education, patient-specific cutting and drilling guides, and customized implants and implant moulds. Ms. Sangita Reddy, Joint Managing Director, Apollo Hospitals Group said, “3D-printing is today used in a wide range of healthcare settings and is helping to save and improve lives in ways never imagined until now. 3D-printing has many applications in healthcare and the in-house 3D-printing labs at the hospitals will enable better patient care and treatment planning. Advances in 3D printing technology today produces customized, lighter, stronger, safer and higher performing products with reduced lead times and lower costs. This gives doctors with a better understanding of their patients and improves patient comfort level with products that are designed especially for their anatomy. Patient-specific design of implantable devices and surgical tools will help optimize surgical processes and costs. In areas such as spinal surgery, customised 3D-printing will add value to personalized medicine, enhancing pre-operative planning, leading to shorter operation times and helping to reduce risk for the patient. 3D-printing will also help improve the skills of the new generation of surgeons with a better understanding of the disease involved. This is just the beginning and as the technology continues to develop, we will see the unlocking of the full potential of 3D-printing in healthcare.” Ms Firoza Kothari, Co-founder and CTO Anatomiz3D said, “Ever since 2015, Anatomiz3D has believed in the potential of 3D Printing in personalizing healthcare and has seen itself follow a path to translate its vision to a reality. Our strategic collaboration with Apollo Hospitals, a progressive organization and one of the pioneers in adopting new technologies early on that are beneficial to its patients, is a strong step towards such large scale translation. Over the years, we have had the opportunity to work with multiple clinicians associated with Apollo Hospitals, and it is a moment of pleasure and pride for us to bring this technology to them directly in their facility, to use in their practice as well as explore in research and development. Together, Apollo Hospitals and Anatomiz3D aim to make customized medical devices easily accessible to patients, for an enhanced quality of life” Anatomiz3D uses technology that has been proven in over 1000 cases. A multi-disciplinary team consisting of Biomedical Engineers, Mechanical Engineers, AM Engineers, 3D Designers will work with Apollo Hospitals medical and surgical talent in the Hospital 3D-printing labs. The lab will provide Anatomical Models that are life-size replicas of a patient’s anatomy, accurately reconstructed from their CT/MRI scans into 3D models, which can be created in multiple materials, colours, opacities and hardness to provide advanced 3D visualization for pre-surgical planning and patient communication; Implants and Molds that are custom designed to perfectly match the defect region in a patient, would ensure an ideal aesthetic and functional fit. 3D printed in biocompatible material; and, Surgical guides and tools fit on a predetermined area of a patient’s bone and guides a surgical saw or drill in a pre-planned direction, ensuring a precise surgical outcome.

A 5-month-old infant became the youngest child to undergo a successful heart transplant at Indraprastha Apollo Hospitals on 13th January 2021. At birth, the baby was diagnosed with poor heart function (dilated cardiomyopathy) due to multiple holes in the left chamber of the heart. Consequently, the blood that was supposed to reach the heart was getting drained out, hampering its smooth functioning. The baby was brought to the Emergency with no pulse and BP. He was resuscitated successfully after 4 hours of continuous efforts by the Emergency team and then his condition was stabilized in the NICU. Since the baby required a heart transplant, he was registered with NOTTO on the very day of his admission and the child received a heart from a 20-month-old cadaver donor. A team of experts led by Dr Bhaba Nand Das, Senior Consultant, Pediatric Cardiology (Surgical) and his team comprising of Dr Rajesh Sharma, Senior Consultant, Pediatric Cardiology and Cardio Thoracic Surgery, Dr Mukesh Goel, Senior Consultant, Cardio Thoracic Surgery, Dr Deepa Sarkar & Dr Vikas Anesthesiologists, Dr Manisha Chakraborty, Cardiologist, Dr Muthu Jothi, Senior Consultant, Pediatric Cardiology and Dr Reetesh Gupta, Paediatric Cardiac Intensivist, conducted this transplant procedure and the process of procuring the organ. Dr Bhaba Nand Das, Senior Consultant, Cardio Thoracic Surgery, Indraprastha Apollo Hospitals, said, “A human body requires a heart transplant as a definitive treatment in case of an end stage heart failure, where medical therapies and external supports are not able to control and revive heart function. Generally, all transplants are done with a matching blood group donor, including heart transplant. But in case of children where it is very difficult to get organs in the first place, getting a matching blood group donor is extremely rare. Therefore, for children we do accept mismatched blood group transplants.” “Like in the case of this child, his blood group was O+ and the donor child was AB+. While most of the times no complication arises, but in case of any, there are certain modalities and therapies like plasma exchange that we do, if such a situation arises.” Dr Mukesh Goel, Senior Consultant, Cardio Thoracic Surgery, Indraprastha Apollo Hospitals said, “All the organs harvested from the donor should be transplanted into the recipient within a specific time duration. For the heart, it is 4 hours, because once the organ is taken out of a body, it stops getting oxygen, blood supply and other nutrients and consequently the cells of the organ start dying. Therefore, in case of heart transplant, if it is transplanted into another person after 4 hours, the organ may not function properly. Post that depending on the patient’s condition many of them may require temporary ECMO support till the organ regains full function on its own.” Dr Muthu Jothi, Senior Consultant, Pediatric Cardiothoracic Surgery, Interventional Cardiology at Indraprastha Apollo Hospitals, said, “When the child was admitted with us, his heart was unable to function unless on ventilator support. While we knew only a heart transplant could save the child, getting a heart for a child as young as him was very rare and difficult. Nevertheless, on the very first day we had registered him with NOTTO and on 8th January we were notified that parents of a brain dead child (20-month-old) were willing to donate his heart, kidney and liver. A special Green Corridor was created through which the team could bring the organ back to the hospital within 17 minutes and exactly within 2 hours 5 minutes the heart transplant was done successfully.” The child is under observation and he will be put on anti-rejection therapy to ensure that the heart functions normally.

In the past few months, COVID 19 has been associated with many severe health complications that it poses in the long run. Doctors at Indraprastha Apollo Hospital, came across one such rare case, which might be the first reported case of post-covid encephalitis in India. 55-year-old Mr. Mitlesh Labru from Jammu was diagnosed with Acute haemorrhagic LeukoEncephalitis: a neurological disorder: Encephalitis means inflammation in the brain. Mr. Labru had contracted COVID 19 with mild symptoms, post which he went into home quarantine. However, his condition deteriorated rapidly leading to shortness of breath. He was urgently shifted to a local hospital in Jammu. Diagnosis revealed that owing to COVID 19 the patient had contracted Pneumonia of the Lungs and was hence put on ventilator. The doctors were not sure about the line of treatment considering the complexity and risk factors associated with patient’s health as he suffered from multiple co-morbidities such as Diabetes and Hypertension. Thus, the local doctors had to call in a team of experts from Indraprastha Apollo Hospitals, New Delhi. Within 24 Hours, an expert team of doctors comprising of Dr Mukesh Goel (Senior Consultant, Cardio Thoracic Surgeon), Dr Devjeevan (Senior Interventionist), Dr Priyadarshini Pal (Head of Emergency, Indraprastha Apollo Hospitals) along with a perfusionist (a healthcare professional who operates the ECMO machine) and a nursing assistant was formed. This team flew to Jammu, stabilised his oxygen ventilation and got the patient to Delhi via an air ambulance for further investigations and immediate treatment, considering the fact that any further delay in treatment would have led to loss of life for the patient. He was admitted to Indraprastha Apollo Hospitals on December 1st 2020, under the supervision of Dr Rajesh Chawla, Senior Consultant, Pulmonology & Respiratory Disease. Supervising the case, Dr Rajesh Chawla, Senior Consultant, Pulmonology & Respiratory Disease, said, “When the team reached Jammu the patient was in a critical condition and unfit for travelling even on ECMO support, considering the fact that his lungs had been severely affected due to Pneumonia and were not functioning properly. We first tried to stabilize his health as only post that he would be fit to be shifted via an air ambulance to Delhi. At Apollo he was admitted to the COVID ICU ward and we monitored his condition closely. While the patient manifested signs of recovery from COVID pneumonia within 2 days and was removed from the ventilator, we noticed that he had slipped into deep coma due to an underlying condition in his brain.” Dr Vinit Suri, Senior Consultant, Neurosciences, Indraprastha Apollo Hospitals, said, “Usually when patients recovering from COVID pneumonia are removed from sedation and muscle relaxants (after being on a ventilator) they come back to consciousness within hours, but that was not the case with Mr Labru. His MRI revealed that there were multiple swellings in the brain along with over 400 micro blood clots (haemorrhagic spots). This condition has been identified as COVID Encephalitis (Acute haemorrhagic LeukoEncephalitis). Fortunately, we were able to diagnose this condition on time and with immune therapy and steroids we were able to gradually revive the patient within 7 days to a complete state of consciousness and alertness. While he still has slight weakness in his limbs, his post treatment MRI shows more than 50% recovery and the patient has been discharged on 26th December.” Encephalitis causes inflammation in the brain and is manifested by epileptic seizures, fever and headache. Association of COVID 19 with Encephalitis is rare and only few cases have been reported worldwide.

Mr. Mahboob Rahman, a 51-year-old from Murshidabad, was diagnosed with advanced pancreatic adenocarcinoma. In 2019, he was suffering from jaundice for which he underwent stenting to relieve the jaundice. He then underwent two more stenting surgeries at a hospital in Midnapore, West Bengal. He was later brought to Apollo Gleneagles Hospitals, Kolkata and was diagnosed with a mass at the pancreatic head. The team of doctors at Apollo Gleneagles Hospitals, Kolkata successfully performed a complex surgery, which involved replacing the portal vein damaged by the pancreatic cancer with artificial graft tube (PTFE graft), a first for Eastern India. Read more about the Whipple procedure performed to treat pancreatic cancer with portal vein invasion.

Doctors at Indraprastha Apollo Hospitals, New Delhi, successfully performed a bone marrow transplant on a 17-month-old Filipino baby, for what can be called as world’s first ever bone marrow transplant for a novel mutation in the blood (NF-E2). As a first of its kind case to have ever been reported in the world (first published in British Journal of Hematology), the doctors at Dubai were not fully equipped to conduct a Bone Marrow Transplant for such a condition. Hence, they referred him to India to Dr Gaurav Kharya, Clinical Lead, Centre for Bone Marrow Transplant and Cellular Therapy & Senior Consultant, Pediatric Hematology, Oncology and Immunology, Indraprastha Apollo Hospitals, New Delhi. Dr Atish Bakane, Associate Consultant, Centre for Pediatric Hematology Oncology, BMT and Cellular Therapies at Indraprastha Apollo Hospitals said, “This was a challenging case for us because we had never dealt with this novel mutation. Different blood mutations react to chemotherapy drugs in a different manner, hence we closely monitored this procedure and fortunately we were able to save the baby.” Read more about how the rare novel mutation in blood (NF-E2) was treated.