APPSPGHAN 2022

Anupam Sibal

Group Medical Director, Apollo Hospitals Group

India

Group Medical Director, Apollo Hospitals Group since September 2005
President, Global Association of Physicians of Indian Origin (GAPIO) in January 2020
Member of the Regional Middle East International Advisory Board of Joint Commission International (JCI) since 2011
Member of Institute Body, PGIMER Chandigarh (2009 – 2014)
Honorary Clinical Professor at Macquarie University, Sydney in Australia
Major Achievements:
Helped set up the first successful liver transplant programme in India in 1998 at Apollo Hospitals.
The Apollo Transplant Program is the busiest solid organ transplant program in the world since 2012.
More than 3900 liver transplants have been performed of which 434 are pediatric.
124 publications,15 chapters, more than 401 National and International lectures
Edited a Textbook in Pediatric Gastroenterology and Hepatology and Nutrition published in 2015.
Author of the National best seller "Is Your Child Ready to face the World”?
The Apollo Transplant Program is the busiest solid organ transplant program in the world since 2012.

Liver Transplant Program In Resource-Limited Setting: Current Issues And Challenges

Liver Symposium: Liver Transplantation in Asia

14 October 2022 (1330-1500) @ Sipadan Hall 2

A sustainable pediatric liver transplant program requires a comprehensive approach – early diagnosis, timely referral, and coordination between the private and public healthcare sectors. Many countries in Asia and Africa with limited resources do not have these structures in place. The lack of economic development in developing countries is a crucial hurdle to access LT. Managing malnutrition and infectious diseases are given due precedence over transplantation and therefore, LT remains largely unavailable in the public sector. With the absence of universal insurance cover, the onus of funding is largely on the family. Need for regular follow- up and cost of immunosuppression add to the economic drain.

About 3 decades after its inception in the West, the first successful pediatric liver transplant in India was performed at Apollo Hospitals, New Delhi in November 1998. Overcoming the hurdles of financial constraints, reservations about organ donation and donor safety in a largely living related program, India is now amongst the leading centers for LT in Asia. Between 1500-2000 transplants a year are performed, 10% of which are pediatric. Survival rates surpassing 90% have been achieved. The Apollo Liver Transplant Program has now performed more than 4000 liver transplants in patients from 50 countries. Of these 456 are pediatric transplants. The recipient of the first successful pediatric liver transplant in India, Sanjay then a twenty two month old baby is now working as a doctor in Bangalore. Children from 20 countries have received a transplant in our center.

Over the years, indications and donor pool have expanded. Age, size and now cost is no longer a barrier for successful LT. Babies weighing as little as 3.5 kg have received a successful transplant, Combined liver kidney transplants and ABO incompatible liver transplants are routinely performed. The average cost is 30,000 USD which is about one-fifth to one-tenth the cost in the West. Crowd funding along with the support of some philanthropic organizations and individuals dedicated to funding LT has thus made transplantation possible for those with limited resources. With increasing acceptance of LT among the medical community and the public at large, LT is now well established.

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