Magnets restore bile flow in liver transplant patient at Chennai hospital
Doctors at MIOT International in Chennai have successfully used a magnetic compression technique to treat a complete bile duct blockage in a post-liver transplant patient, avoiding the need for major repeat surgery.
The patient, a 43-year-old woman from Kyrgyzstan, underwent a living donor liver transplant in 2025. A year later, she developed itching and jaundice. Evaluation at MIOT revealed a complete blockage of the bile duct, preventing normal bile flow from the liver. If left untreated, the condition could lead to severe infection, sepsis, and failure of the transplanted liver.
Dr. Karthik Mathivanan, programme director of the Department of Liver and Multi-Organ Transplant and HPB Surgeon, explained that bile duct strictures occur in up to 42% of living donor liver transplant recipients. While most cases can be managed with endoscopic stenting or percutaneous transhepatic biliary drainage, the patient's bile duct was completely sealed. Despite multiple attempts, doctors were unable to cross the blockage or place a stent.
The aim was to avoid complex repeat surgery, Dr. Mathivanan said. Doctors inserted an external biliary drainage catheter to allow bile to drain outside the body. A multidisciplinary team, including the liver transplant team, interventional radiologists, therapeutic endoscopists, and anaesthesiologists, performed magnetic compression anastomosis (MCA)—a procedure used at a few centres in South Korea and Japan.
In MCA, a gastroenterologist placed a magnet through an endoscope from inside the intestine, while an interventional radiologist introduced a second magnet through the existing drainage tract. The magnets were positioned on either side of the blocked bile duct. Over time, the magnets gently attracted each other, compressing the scar tissue between them.
Dr. Karthikeyan Damodaran, Director of Vascular and Interventional Radiology, said the position was checked through X-ray after a week. Two weeks later, there was no space between the magnets and the blockage was cleared. A stent was then placed to maintain bile flow.
Dr. Mallika Mohandas, chairman, and Dr. Palaniappan S., senior medical gastroenterologist, hepatologist and interventional endoscopist, were part of the team.
