Mumbai: After not being able to eat a morsel of food or sip water for over six months, 58-year-old Abhay Oak had his first bowl of khichdi last week. This was possible as the 58-year-old Ratnagiri resident underwent a small bowel or intestine transplant in a city hospital.His transplant wasn’t simple because of his malnourished frame; in the six months since he had undergone a surgery to remove a gangrene in his small intestine, his abdomen had shrunk, and his weight had halved to 35kg. He hadn’t reacted well to total parenteral nutrition (usually injected into the patient’s bloodstream).“As the brain-dead donor was 18 years old and weighed 80kg, her intestines couldn’t have fitted into Oak’s shrunken abdominal space,” said gastrointestinal surgeon Dr Gaurav Chaubal who performed the small bowel transplant for Oak at Nanavati Max Hospital, Juhu, on May 23.He decided to do a partial graft (a piece of living tissue that is transplanted) using 200cm of the intestines instead of the total length of up to 600cm. The usual practice is to transplant the entire small intestine from brain-dead donors.Dr Chaubal said that finding an appropriate-sized small intestinal graft for a slightly built adult or a paediatric recipient is a challenge, and mismatched transplants could cause abdominal compartment syndrome. But Oak’s case proves that reduced bowel grafts work well, he said, adding that many patients can benefit from this technique.Oak’s wife Ketaki said he developed severe abdominal pain in Nov 2024. Local doctors found there was no blood flow to his intestines, and “asked us to head to Mumbai”, she said. The gangrene in his intestine was removed at the BMC-run KEM Hospital, Parel. “We returned to Ratnagiri, but his health suffered as there was no absorption of nutrients occurring in his gastrointestinal tract,” she said. They found out about Dr Chaubal, who has conducted 20 small bowel transplants in the last five years. Within a couple of months of registering for a deceased donor, they found a match. “We are now relieved,” she said.