Transplant surgery in India has long been a formidable challenge, marked by limited accessibility, surgical complexities, and deep-seated apprehensions. Today, the field of transplant surgery is undergoing a transformation, driven by minimally invasive techniques that are redefining possibilities. With innovations in laparoscopic and robotic surgery, along with breakthroughs in immunotherapy, procedures are becoming less invasive, reducing recovery times and post-operative pain. However, some transplants continue to face skepticism, none more so than pancreas transplants. In India, patients have often been discouraged not only by their families but also by doctors who consider the procedure too risky.

Determined to change this narrative, Dr Suresh Raghavaiah, one of India’s pioneering transplant surgeons, dedicated years to building trust in pancreas transplantation. As the second Indian to complete a laparoscopic HPB fellowship in Paris and among the few to undergo an Abdominal Multi-Organ Transplant surgical fellowship at the famous Mayo Clinic in Rochester, he returned to India with a mission to push the boundaries of organ transplantation. Through his relentless efforts in education, advocacy, and surgical excellence, Dr Suresh helped establish pancreas transplants as a viable option, despite initial resistance.

Dr Suresh has since expanded access to multi-organ transplants, including liver, kidney, pancreas and small intestinal transplants, introducing advanced surgical techniques, and addressing the challenges of post-transplant care in a system with limited insurance coverage. From being part of the team which performed Punjab’s first liver transplant to achieve the highest series of liver and pancreas transplants in the state of Karnataka, his work has redefined transplant surgery in India, making once-impossible procedures a reality.

Starting from Scratch to Pioneering Transplant Innovations
Dr Suresh, the first doctor in his family of Agriculturists, completed his MBBS at Adichunchanagiri Institute of Medical Sciences, Bellur, and thereafter pursued general surgery training at St. John’s Medical College, Bangalore, a premier institution for surgical education. His pursuit of excellence led him to the prestigious IHPBA Fellowship in minimally invasive Hepatobiliary surgery in Paris, where he trained under Prof. Brice Gayet, who is one of the pioneers of laparoscopic liver surgery.

Pursuing his interest in Immunology, he completed a basic science Post-doc Research Fellowship in transplant immunology at the Mayo Clinic, Rochester, under Prof. Stegall, one of the most cited experts in the field. During his fellowship, he collaborated with Prof. Stegall in researching several drugs to treat antibody-related transplant complications after Kidney Transplant. He then transitioned into a clinical fellowship at the Mayo Clinic, gaining experience in liver, kidney, and pancreas transplants, as well as HPB surgeries.

Upon his return to India, Dr Suresh played a key role in advancing organ transplantation in Ludhiana, Punjab, addressing the state’s

growing burden of liver disease. Post that, he moved to Bangalore, joining Gleneagles BGS Hospital, Kengeri, Bengaluru and is credited to have performed the maximum number of Pancreas Transplants in the State. He later took on the role of Multi-Organ Transplant Surgeon at Apollo Hospitals in Karnataka for four years following which he returned to Gleneagles BGS Hospital, Kengeri, Bengaluru, where he now leads the HPB and multi-organ transplant unit.

Shaping a Collaborative & Trusted Approach to Transplantation
Dr Suresh’s expertise in organ transplantation is shaped by extensive international training. His exposure to advanced surgical techniques gave him a well-rounded understanding of the field, an opportunity that was rare in India in those days. Bringing this knowledge back, he has played a key role in advancing liver transplantation, particularly in living donor procedures, where India now ranks second globally.

Success in transplant surgery is never an individual effort. “It is always a collective achievement”, says Dr Suresh. Every successful transplant involves at least 25 specialists working together, from surgeons and anaesthetists to intensivists and nursing staff.

Transplantation is more than an operation, it’s a second chance at life

Evolving Challenges in Transplantation
With lifestyle diseases on the rise, organ failure is becoming a growing concern. “Over the past decade, I have witnessed a shift from single-organ failure to more complex multi-organ failures,” says Dr Suresh. This has increased the demand for multi-organ transplants like liver-kidney and kidney-pancreas transplants, which his team has successfully performed in Karnataka.

Dr Suresh’s expertise in these high-risk surgeries has helped establish his institute among the top in Karnataka and the second in India for pancreas transplants.

Beyond the surgical challenges, organ rejection remains one of the biggest hurdles in transplantation. While a first transplant is usually successful, patients who have had multiple blood transfusions or previous organ transplants often develop antibodies that aggressively reject a second transplant. During his research at the Mayo Clinic, Dr Suresh worked on solutions for this issue, especially in kidney failure patients. With new antibody-lowering treatments, the chances of success improved significantly. These advances are now available in India, giving more patients access to life-saving transplants..

Finding Balance in a Demanding Field
Transplant surgery is intense. It comes with long hours, unpredictable schedules, and procedures that often stretch through the night. Finding balance isn’t easy, but having a reliable team makes all the difference. “I trust my team completely, which allows me to step away when needed, spend time with my family, and even take a vacation without worrying about patient care”, says Dr Suresh.

No matter how demanding the work is, the impact makes it worthwhile. “Nothing compares to seeing a patient who once had no hope of survival return years later to share his milestones”, he says.

The Future of Liver Transplants in India
India is among the leading countries in liver transplants, yet organ donation rates remain critically low for its vast population. As a result, countless patients lose their lives while waiting for an organ.

New medical advancements like machine perfusion and donation after cardiac death are already transforming transplant medicine in the West. These technologies allow organs to be preserved and assessed before transplantation, making more organs suitable for transplant. While India has yet to fully integrate these innovations, they hold immense potential to expand organ availability and improve transplant success rates.

A stronger organ donation culture would not only save lives but also reduce transplant costs, making the procedure more accessible. Each person has the power to give someone a second chance at life. Pledging to be an organ donor is a simple step that can make a profound impact.

Dr Suresh Raghavaiah, Senior Consultant and Head(HPB & Multi-Organ Transplant)
•MS(General Surgery) - St John's Medical College &
Hospital, Bangalore
•IHPBA fellowship in Minimally Invasive HPB Surgery - Paris
•Multi-Organ Transplant Fellowship - Mayo Clinic, USA
•Post-Doc in Transplant Immunology - Mayo Clinic, USA
•Mayo Bronze Quality Fellow
•Member - Priestly Society of Surgeons
•Invited Faculty at National and International Events