In a rare liver swap transplant surgery involving four persons -- two donors and two recipients -- the lives of a Mumbai doctor and a Kolhapur farmer suffering from end-stage liver failures were saved at the Sir HN Reliance Foundation Hospital, an official said here on Thursday.

The four surgeries, performed simultaneously by a team of nearly three dozen surgeons toiling for 14 hours in four operation theatres, finally resulted in the 55-year old medico and 36-year old peasant getting new livers - and a new lease of life, said the HNRFH CEO Tarang Gianchandani.

"Until four months ago, both patients were oblivious of each other's very existence, little realizing that their destinies could be so closely intertwined and they could have successful liver transplants which would connect them forever," said Gianchandani.

The ailing duo had lost all hopes as the only available family donors, their wives, were of different blood groups.

Director and Chief Transplant Surgeon, (Dr.) A.S. Soin

Soin added that the biggest challenge in such swap transplants was to perform the surgeries simultaneously on both the donors and the recipients, since one or the other donor could back out after their relative receives a transplant.

Gianchandani said that besides the HNRFH, only a handful of hospitals in India and abroad have the expertise, infrastructure and coordination to perform such challenging tasks.

Though kidney swaps are common, such exchanges are rare in liver transplantation as the operations are far more intricate taking 8-10 hours each, must be performed with zero error, and besides the blood group, even the liver sizes must match for the donor and the patient.

Soin said of the around 3,100 liver transplants at the HNRFH, 43 were swaps in 86 patients, the highest such experience in the world.

Now, the hospital is developing an Artificial Intelligence-based exchange algorithm that can match patient-donor pairs to maximize the number of transplants, inter-hospital and inter-city swap, besides debating the possibility of swaps between different organs, like aliver for kidney'.

Director of Gastroenterology and Hepatobiliary Science Chetan Bhatt said in the latest case, both patients were very ill and would not have survived beyond a few months.

"The successful exchange is an outstanding example of how sharing of human suffering and joy transcended social barriers and united two families. The swap option is a blessing in times of organ donor shortage," Bhatt pointed out.

Gianchandani said three weeks after the swap, the two patients and the donors are convalescing well, put on normal diet and fast returning to their normal lives.