Recently, a live heart transported to Chennai saved a patient in the nick of time. Months before that, a bone airlifted from Italy had given a new lease of life to a Yemen native. The girl, who underwent the surgery in India in February, is back on her feet now.
Maram Mohammed Sahel, 20, a medical student from Sana’a, Yemen, was diagnosed with bone cancer one year ago at a city hospital. Though the tumour in her elbow wasn’t found to be malignant at first, it kept growing in size. Doctors at HCG, a cancer-care hospital, sent a worldwide request for a matching custom elbow joint and fresh frozen allograft of the elbow. A matching bone harvested from a cadaver donor was airlifted from Istituto Ortopedico Rizzoli, Italy, in January 2014.
How was it done? “We have to match the bone size with the patient’s age. In Maram’s case, we luckily got a matching bone from a brain-dead patient. As soon as the bone was harvested, it was immersed in liquid nitrogen and maintained at minus 80 degrees C. It took two days for it to reach Bangalore from a bone bank in Italy,” said Dr Pramod S Chinder, consultant orthopaedic oncology in India, who operated on Maram in February.
In a 12-hour surgery, Maram underwent Allograft Prosthetic Composite (APC), a procedure that replaces the removed bone stock with an allograft but combines it with a metallic implant. Bone banks have bones harvested from cadaver donors as well as live donors, who go in for a joint replacement or hip replacement. Though the bones are maintained in freezers, there is a possibility of them losing strength gradually. To prevent this, radiation is carried out before transplanting the bone. In Maram’s case, there was no need of radiation as the bone was freshly harvested from the brain-dead patient and used immediately.
Maram comes from a family with a medical background; her mother is a gynaec-oncologist. “She (the girl) is brave and knowledgeable,” said Dr Pramod.
There is not much awareness in India about conservation of bones of brain-dead patients, said doctors who are initiating a bone bank at HCG.
I underwent two surgeries for tumour removal. One in Egypt three years ago and the second in India. In both cases, the biopsy found the tumour wasn’t malignant. But it kept getting larger. Doctors at HCG confirmed bone cancerorthopaedic oncology in India. Many doctors told me to go for amputation
Maram Mohammed Sahel, medical student from Yemen
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