The first successful split liver transplantation in India was performed at Global Hospital Chennai on 16/9/09.  Split liver Transplantation involves dividing a cadaver donor liver into two halves for transplantation of two patients as life saving procedures.  There is an acute shortage of cadaver donors throughout the world.  As a result of this the technique of splitting one liver for two recipient was developed in Europe.  Dr Mohamed Rela pioneered this technique at King’s College Hospital London. The operation was performed for the first time in India under his leadership at Global Hospital Chennai.  Dr Mohamed Rela is a leading liver transplant surgeon in the world having performed over 1200 liver transplants. He is currently leading the liver transplant team at Global Hospital Chennai, Bangalore and Hyderabad.
The donor liver came from a young man who died of road traffic accident in Salem.  The parents were very keen for all of his organs to be used for transplantation to save as many lives as possible.  In order to fulfill their wishes, it was decided to use the liver for two recipients.  The liver was split during the retrieval operation into a smaller left lobe for transplanting a young girl and a larger right lobe for transplanting an older woman with end stage liver disease.  The donor procedure and the two transplant operations took over 20 hours and involved a team of 6 surgeons and 6 anaesthetists and a large number of support staff.  Both recipients are recovering well from the operation.
The young girl suffered from a rare liver condition called Crigler Najjar Syndrome which causes jaundice from birth.  If this jaundice is not controlled properly it causes neurological damage.  Dr Mohamed Rela performed a novel procedure called Auxiliary liver transplantation using the split left lobe from the donor.  This procedure again was performed for the first time in India.  Auxiliary liver Transplantation (ALT) is a complex procedure and there are very few centres in the world where it is performed.   Dr Mohamed Rela is a world authority in this operation and has performed the largest number of Auxiliary Liver Transplantation in the world while working at King’s College Hospital, London. 
Patients undergoing any transplant operation have to remain on lifelong immunosuppressive drugs which are expensive and if not monitored properly can lead to serious side effects.  The advantage of Auxiliary liver transplantation is that there is a potential to withdraw patients from long term immunosuppressive drugs. 
During standard liver transplantation, all of the diseased liver is removed and replaced by a new liver.  In Auxiliary liver transplantation, in contrast most of the recipient liver is retained and only part of the liver is replaced with a new graft.  This procedure has application in two types of liver disorders

In acute liver failure, patient’s own liver has the potential to regenerate and recover.  Patient’s own liver which is retained in ALT will regenerate over 6 to 12 months and when it is fully regenerated, immunosuppression can be stopped.

In metabolic liver disease, Gene therapy techniques are being developed as a cure instead of liver transplantation.  In Auxiliary Liver Transplantation, the retained liver can be the target for future gene therapy with cure for the condition once again with the advantage of stopping long term immunosuppressive drugs sparing the patients from the cost and side effects of immune suppression.