Chennai father donates small intestine to 4-year-old son, both safe after transplant

After a marathon seven-hour long surgery, eight doctors and 24 nurses in Chennai have successfully saved the life of a four-year-old boy who had completely lost the functioning of his small intestine. Doctors completed the surgery by removing precisely 150 cm of the boy’s father Swaminathan’s small intestine and transplanting it into the boy. 

Three months after the successful surgery, doctors decided to open up about the extremely rare condition faced by the boy and the complicated surgery that followed. 

It all began when the four-year-old boy Guhan complained of sudden and erratic vomiting. On visiting a hospital, the family learnt that their son was diagnosed with a condition known as ‘Volvulus’, which meant that his smaller intestine was twisted and thereby cut off from blood flow. Hence, all the cells in his small intestine were dying and the organ was losing its function. As absorption of nutrients is the key function of the small intestine, its failure implied a serious threat to the young boy’s life. 

The parents had to allow the doctors to remove his entire small intestine in order to save him as no other treatment seemed possible. However, the young boy had to endure extreme hardships as he was endlessly hooked onto intravenous feeding (nutrients being fed directly into the bloodstream), even for basic sustenance. He couldn’t eat like normal kids of his age as the food he ingested caused further health complications in his already fragile body. 

Later, on consulting Rela Hospital in Chennai, the family was made aware of the possibility of intestinal transplantation. Despite the risks, they went ahead with the procedure as it was the only hope to save their ailing son. Swaminathan donated 150 cm of his small intestine (which could be as long as six meters) for the transplant. 

Senior Consultant, Liver and Gastro specialist for children at Rela Hospital – Dr Naresh Shanmugam explained that Volvulus occurred only in two per thousand cases and was an issue recorded during the initial growth years. He added that twisted intestines could surgically be untwisted if the condition is detected early enough. 

When questioned about how the 150 cm long transplanted small intestine could carry out the function of an organ that otherwise spans up to six meters in length, the doctor explained to WION/Zee Media that it would eventually be functional and last the boy his entire lifetime. 

According to Professor Mohamed Rela, who headed the team that performed the surgery, such transplants always involve the risk of organ rejection by the recipient. However, in this case, adequate care was provided to mitigate the possibility of an issue. He also explained that intestine transplants like this one can’t be done from one living adult to another. In the case of adults, such organs can only be removed from cadavers, he added. 

“For those that suffer complete small intestine failure, only intravenous nutrition would be possible. However, even that is not viable after 10-15 years. In most cases, it leads to gradual loss of life”, Prof. Rela explained. “Intestine transplants are not as common as liver or kidney transplants”, he added. 

After the surgery was successfully completed on September 13, 2021, Guhan had to completely depend upon intravenous nutrition for several months. As the new organ was gradually accepted by his system, he was permitted to resume consumption of normal food and his father (the donor) could also resume regular activities.

According to Guhan’s parents, going in for the transplant was terrifying but they went ahead with it owing to the doctors’ reassurance and for giving their son a second chance at life. 
According to the Asia Book of Records, this transplant procedure was recognised as Asia’s Youngest Small Intestine Transplant surgery.