In a groundbreaking achievement for Indian healthcare, two hospitals in Coimbatore have collaboratively performed the country's first-ever inter-hospital swap liver transplant, giving a new lease on life to two patients suffering from end-stage liver disease. 

A press and media briefing about this procedure was held in Chennai on Friday, where it was conveyed that this complex procedure was successfully executed through a joint effort between GEM Hospital and Sri Ramakrishna Hospitalin Coimbatore — marking a historic medical feat that required meticulous planning right from the stage of patient evaluation, donor-recipient matching, comprehensive pre-operative optimizationand unprecedented inter-institutional cooperation.

The patients, a 59-year-old man from Salem admitted in GEM Hospital and a 53-year-old man from Tiruppuradmitted in Sri Ramakrishna Hospital, were both in dire need of liver transplants. Their respective wives were willing to donate, but blood group incompatibility ruled out direct donation. In a rare stroke of opportunity, doctors identified that a ‘swap transplant’—where the donor of each patient gives to the other, was the only viable solution. Finally, the surgery was simultaneously performed at both the hospitals on 3rd July 2025.

Unlike conventional living donor liver transplantation, where a relative donates directly to the patient, a swap transplant enables patients who do not have a compatible donor within their own family to exchange donors with another family in a similar situation. This approach expands the donor pool and offers new hope to patients with end-stage liver disease who would otherwise remain on long waiting lists or have no viable curative treatment option.

What makes this case historic is not just the medical complexity, but that the swap occurred across two different hospitals, a scenario never before attempted in India for liver transplants.

“This required navigating a host of legal, ethical, and logistical challenges,” said Dr. C.Palanivelu, Founder & Chairman - GEM Hospitals. “We had to obtain special clearance from the Tamil Nadu State Transplant Authority to transport the organ from one hospital to the other. We also had to ensure synchronized surgeries and establish a real-time communication protocol between both hospitals.”

Dr. P.Praveen Raj, Director – GEM Hospitals, emphasized the legal rigor involved: “Swap transplants are already regulated under the Transplantation of Human Organs Act 2014, but inter-hospital coordination added new layers of scrutiny. We had to present detailed consent forms, cross-institutional MOUs, and continuous ethical oversight.”

Dr. N.Anand Vijay, Liver Transplant Surgeon- GEM Hospital said, “On the day of the transplant, both hospitals performed the surgeries simultaneously in two different operation theatres located 5 kilometers apart. Real-time video feeds were established to monitor surgical progress and co-ordinate liver retrieval and transplantation. Dedicated ambulances equipped with cold chain systems were kept on standby, but both donors and recipients remained in their respective hospitals throughout, making this a true logistical marvel”.

R. Sundar, Managing Trustee – Sri Ramakrishna Hospital said, “Tamil Nadu has long been recognised for its exceptional healthcare infrastructure, and this milestone stands as a true testament to Tamilnadu's medical excellence. The highly skilled medical teams from GEM Hospital and Sri Ramakrishna Hospital undertook this complex procedure with great precision and dedication. Their tireless efforts have led to a remarkable success, and I am extremely pleased to note that both patients are recovering well. Our sincere gratitude also goes to the Transplant Authority of Tamil Nadu (TRANSTAN) for granting timely approval and supporting this life-saving initiative.”

“Moments like this remind us of the critical importance of organ donation. Across India, thousands of patients are waiting for a second chance at life through organ transplants. I humbly appeal to everyone to consider becoming organ donors and be part of this noble cause”, Mr.Sundar further added.

Dr.R.Jayapal, Liver Transplant Surgeon - Sri Ramakrishna Hospitalsaid, “This innovative approach helped avoid the need for costly ABO-incompatible liver transplantation, which would have been the only alternative option in this scenario. By enabling a compatible swap, the teams successfully reduced the financial burden on patients, thus underscoring the commitment of both hospitals to delivering the highest quality outcomes while preventing unnecessary expenses. This milestone opens a new economic avenue in liver transplantation, proving that cost-effectiveness and clinical excellence can go hand in hand.”

“With over 25,000 Indians dying annually due to liver failure and a shortage of compatible donors, this milestone offers new hope. This success opens the door for more collaborative living donor liver transplant models across hospitals and even across states in the future,” added Dr. C.Palanivelu.

“Both the donors and recipients of the organs are responding well to the medicines and recovering. This achievement is a testimony to what is possible when institutions rise above boundaries for the greater good. We believe this model can now be replicated across India to save more lives”, Dr. N. Anand Vijay further added.

Dr. S Alagappan, Medical Director, Sri Ramakrishna Hospital and other dignitaries were also present in Chennai during the press conference held to brief this achievement to the press media.