What is a Combined Liver-Kidney Transplant for MMA and its Cost?

A Lifesaving Option for MMA: Understanding CLKT and Its Cost in India

Methylmalonic Acidemia (MMA) is a rare and serious genetic metabolic disorder. Patients with MMA face severe complications that sometimes lead to liver and kidney failure. In such cases, a Combined Liver-Kidney Transplant (CLKT) serves as a life-saving treatment. The average cost of CLKT for MMA in India typically ranges from ₹30 lakhs to ₹40 lakhs, depending on hospital infrastructure, donor availability, and post-operative care needs.

What is Methylmalonic Acidemia?

MMA is a rare inherited metabolic disorder. In this condition, the body is not able to break down certain fats and proteins. It results in an accumulation of toxic substances like methylmalonic acid in the blood and organs. MMA can lead to serious health problems like developmental delays, kidney damage, and metabolic crises, which are life-threatening.

What is a Combined Liver-Kidney Transplant?

Surgeons perform CLKT by transplanting both a healthy liver and a kidney, generally from the same donor, into a patient. This approach is often used for patients with MMA. CLKT is considered a recommended treatment for MMA patients with advanced kidney disease (CKD stage 3b or higher), especially when metabolic control cannot be achieved through medical therapy alone.

What is the Cost of a Combined Liver-Kidney Transplant for MMA in India?

The cost of a CLKT procedure for MMA in India generally ranges from Rs. 30 lakhs to Rs. 40 lakhs in India. However, additional costs may arise from pre-transplant evaluation, post-operative care, complications and lifelong immunosuppressive therapy.

How Long Does a Combined Liver-Kidney Transplant Take?

A Combined Liver-Kidney Transplant procedure takes 12-16 hours to complete. The exact duration depends on the condition of the patient, surgical complexity and whether the organs come from single or separate donors.

The procedure begins with a liver transplant, followed by a kidney transplant. After the surgery, patients remain in the ICU for several days to be monitored and ensure a stable recovery.

Why Do Patients Need a Combined Liver-Kidney Transplant for MMA?

In the more severe cases of MMA, especially those that are resistant to any medical management, both the liver and kidneys may fail to function over time. Hence, in such a situation, CLKT can:

• Help reduce the accumulation of toxic substances.
• Improve metabolic control by replacing any faulty enzyme activity with a healthy liver.
• Restore kidney function and eliminate the need for dialysis.
• Improve the overall quality of life and long-term outcomes.

Who is Eligible for a Combined Liver-Kidney Transplant for MMA?

CLKT is generally recommended for individuals with severe forms of MMA that are resistant to any pharmacological treatment. An evaluation of candidates takes place based on their organ function, metabolic stability, age, genetic subtype and overall health to determine readiness for transplant.

A CLKT procedure offers a potential improvement in metabolic control and quality of life for patients with severe MMA, though outcomes depend on individual health status and surgical factors. While the costs can be substantial, the potential improvement in quality of life and long-term survival makes it a great option for suitable candidates. If you are considering this treatment, consult a multidisciplinary transplant team to explore your options for surgery.