In a groundbreaking achievement for Indian healthcare, GEM Hospital and Sri Ramakrishna Hospital in Coimbatore have collaboratively performed the country’s first-ever inter-hospital swap liver transplant, giving a new life to two patients suffering from end-stage liver disease.
This landmark surgery represents a historic medical feat that required meticulous planning from the early stages of patient evaluation, donor-recipient matching, and comprehensive pre-operative optimisation to unprecedented inter-institutional cooperation.
The patients involved were a 59-year-old man from Salem admitted to GEM Hospital and a 53-year-old man from Tiruppur admitted to Sri Ramakrishna Hospital.
Both were in critical need of liver transplants. While their respective wives were willing to donate, their blood groups did not match.
In a rare opportunity, doctors identified that a swap transplant—where each patient’s donor gives to the other—was the only viable solution. The surgeries were performed simultaneously at both hospitals on 3rd July 2025.
Unlike conventional living donor liver transplantation, where a relative donates directly to the patient, a swap transplant allows patients without a compatible donor in their own family to exchange donors with another family in a similar situation.
“This required navigating a host of legal, ethical, and logistical challenges,” said Dr. Palanivelu, Founder and Chairman of GEM Hospitals. “We had to obtain special clearance from the Tamil Nadu State Transplant Authority to transport the organ from one hospital to another. We also ensured synchronised surgeries and established a real-time communication protocol between both hospitals.”
Dr. Praveen Raj, Director of GEM Hospitals, emphasised the legal rigour involved: “Swap transplants are regulated under the Transplantation of Human Organs Act, 2014, but inter-hospital coordination introduced new layers of scrutiny. We had to present detailed consent forms, cross-institutional MoUs, and ensure continuous ethical oversight.”
Dr. Anand Vijay, Liver Transplant Surgeon at GEM Hospital, said, “On the day of the transplant, surgeries were conducted simultaneously in two different operating theatres located five kilometres apart. Real-time video feeds were set up to monitor surgical progress and coordinate liver retrieval and transplantation. Dedicated ambulances equipped with cold-chain systems were on standby, but both donors and recipients remained in their respective hospitals throughout—making this a true logistical marvel.”
- Sundar, Managing Trustee of Sri Ramakrishna Hospital, noted, “Tamil Nadu has long been recognised for its exceptional healthcare infrastructure, and this milestone is a true testament to the state’s medical excellence.
The highly skilled teams from GEM Hospital and Sri Ramakrishna Hospital performed this complex procedure with precision and dedication. We are pleased to share that both patients are recovering well. Our sincere gratitude goes to the Transplant Authority of Tamil Nadu (TRANSTAN) for their timely approval and support.”
“Moments like this remind us of the critical importance of organ donation,” Sundar added. “Thousands of patients across India are waiting for a second chance at life. I humbly appeal to everyone to consider becoming organ donors and support this noble cause.”
The Tamil Nadu Health Department extended full cooperation in expediting the necessary permissions, while law enforcement authorities ensured smooth transportation corridors in case of emergencies.
Dr. Jayapal, Liver Transplant Surgeon at Sri Ramakrishna Hospital, explained, “This innovative approach helped avoid the need for expensive ABO-incompatible liver transplantation, which would have been the only alternative. By enabling a compatible swap, we significantly reduced the financial burden on patients—underscoring both hospitals’ commitment to high-quality and cost-effective care. This success opens a new economic model in liver transplantation, proving that affordability and clinical excellence can coexist.”
Dr. Palanivelu added, “With over 25,000 Indians dying annually due to liver failure and a shortage of compatible donors, this milestone offers new hope. It opens the door for more collaborative living donor liver transplant models, not just across hospitals, but potentially across states in the future.”
Dr. Anand Vijay further stated, “Both the donors and recipients are responding well to treatment and recovering steadily. This achievement is a testament to what can be accomplished when institutions rise above boundaries for the greater good. We believe this model can now be replicated nationwide to save more lives.”
Dr. Alagappan, Medical Director of Sri Ramakrishna Hospital, and other dignitaries were also present during the press conference held in Chennai to share this landmark achievement with the media.
To be noted, GEM Hospital, Coimbatore, was the first in India to perform laparoscopic living donor surgery in 2017.
