A woman dying from lung failure was given a transplant from her two brothers in the Middle East's first operation of its kind to feature live donors.
The complex operation involved 50 doctors working in three separate theatres over 14 hours at a university hospital in Cairo.
The procedure, conducted by a combined team of Egyptian and Japanese doctors, was also the country’s first ever lung transplant.
It saved the life of the Sahar, 28, who was suffering from severe pulmonary fibrosis.
Japanese specialist Hiroshi Date supervised the surgery, four of the Egyptian doctors involved told a popular talk show on Monday.
The patient was not an ideal candidate due to the severity of her lung failure and further problems in the right side of her heart, said Dr Ahmed Moustafa, head of the surgeon team.
The medical team said they considered other patients for the landmark operation, which is expected to put the Ain Shams University Specialised Hospital at the forefront of live-donor transplants in the Middle East.
They said Covid-19 increased the number of patients who, like Sahar, were suffering from pulmonary fibrosis, an important contributing factor in why the procedure was given the green light.
The willingness of Sahar’s brothers, Kamel, 30 and Gomaa, 26, to donate a lobe each, one for the right side of her lungs and one for the left, encouraged the doctors to go ahead with the procedure.
“I can’t imagine what their mother was going through during the operation, to have your three children on the operating table at the same time,” Dr Moustafa said.
The price of such a transplant can be up to 2.5 million Egyptian pounds ($100,000), the doctors said on Monday’s talk show. But the patient was not charged, they said.
However, the doctors said hundreds of millions of pounds was spent updating the hospital in 2015 in preparation for an expansion of its organ donation unit, originally launched in 2008.
Until this year, the unit had only conducted liver and kidney transplants from live patients.
Despite attempts by the Egyptian medical establishment to promote organ donation from the recently-deceased, such procedures have been stalled by cultural barriers.
Several prominent clerics have outlawed it, claiming religious justification, making the problem worse.
“Taking lung tissue from a live patient makes the operation infinitely more complicated because when taking organs from someone who recently passed away, you only need one medical team focused on the one living patient,” said Dr Mohamed Hussein, one of the surgeons.
“We had to dedicate three teams to ensure all three patients came out alive.
“Plus when taking lungs from a deceased person, you can take all of it and give the recipient a complete organ. What we had to do was take portions of her two brothers’ lungs so now all three were living with parts of their lungs missing.”
Despite this, the patients are expected to lead normal lives.
This is why Japanese expertise was invaluable, the medical team said, because of the country’s long history with organ donations from live patients.
“The expertise of the Japanese team was invaluable to completing the operation,” Dr Moustafa said. “What we did essentially was set up a Japanese unit at Ain Shams. There was also co-ordination between the Japanese embassy in Egypt and other government bodies.”
Egypt lags behind most regional countries when it comes to lung transplants, which began in Saudi Arabia in 1998 and the UAE in 2010.