Editorial Team
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A one-year old infant from Kenya underwent a rather unusual liver transplant at Centre for Liver and Biliary Surgery, Indraprastha Apollo Hospital where the liver had to be joined directly to the heart as the child did not have the inferior vena cava. The liver was donated by the child s father.
Paul was suffering from biliary atresia since birth, a condition in which the bile ducts (required to drain the bile from the liver to the intestine) were not developed. This is the commonest reason for liver failure in infants. The condition can be treated by Kasai portoenterostomy operation if detected within 2 months of birth. Unfortunately for Paul, the condition went undetected and he developed liver failure. The only treatment option for him was liver transplant. (Read: Liver transplants: Frequently Asked Questions answered by a renowned liver transplant surgeon)
Prof Anupam Sibal, Group Medical Director and Senior Pediatric Gastroenterologist, Apollo Hospitals, said, Paul s case was high risk case because he was severely malnourished, he was born with a complex anatomy and his liver failure was rapidly worsening. He needed an urgent transplant. We took on the challenge of transplanting such a small baby weighing only 6 kilograms with several risk factors as that was his only hope. We were delighted that he made a remarkable recovery after the liver transplant and his family is delighted to have him back in Kenya. We have now transplanted patients from 22 different countries . (Read: 50-60% of liver transplant patients in India are from foreign)
Dr Subash Gupta, Chief Transplant Surgeon, Indraprastha Apollo Hospitals successfully operated on the child by performing a living donor liver transplant. The child did not have the inferior vena cava (IVC) - the vein which drains blood from the limbs, kidneys and the heart. The living donor liver transplant in itself is quite a difficult operation, the absent of IVC posed an even greater challenge. Special techniques were used to join the liver directly to the heart. Working from the abdomen the lower most part of the right atrium was freed so that the liver could be rejoined to the portion of the heart where the IVC would have joined. The lateral segment of the father s liver was taken out and implanted in the child after removing his native liver. (Read: Now a urine test to detect alcohol use by liver transplant)
Dr Neerav Goyal, Senior Consultant Liver Transplant, Indraprastha Apollo Hospitals, commented, It was a challenging surgery for us since the child was very young and weighed only 6 kgs. Joining of blood vessels is very tricky in such cases since the blood vessels tend to get blocked in young children. Absence of IVC is a rare anomaly and found in about 2% of the patients. (Read: 3D-printed replica for a safe liver transplant created)
The entire operation took 12 hours and involved a medical team consisting of over 50 personnel. Paul had an uneventful recovery and was discharged at 2 weeks following the surgery. Post the surgery, a happy mother exclaimed, We are very thankful to the Apollo team. My son can now lead a normal, healthy childhood. Paul is now on his way back to his country with fond memories.
Press release