Blood group incompatible liver transplant performed from mother after antibody removal
Hospital raises Rs. 35 lakh through crowd-funding and CSR support to provide the child with the life-saving surgery
In a surgery that lasted for 10-hours, a 7-month old baby Abdullah suffering from Biliary Atresia – a rare congenital condition that is seen in one in 10, 000 to 15,000 babies across the world- underwent a liver transplant and through the efforts of doctors at Aster CMI Hospital. A team of doctors including Dr. Sonal Asthana, Lead Consultant – HPB & Liver Transplant Surgery; Dr. Chetan Ginigeri, Lead Consultant – Department of Paediatrics & Neonatology, Dr. V Arun, Lead Consultant, Anesthesia and Critical Care; Dr. Mallikarjun Sakpal, Consultant, Hepatology & Liver Transplant; Dr. Karthik Raichurkar, Consultant- HPB and Liver Transplant Surgery; Dr. Rajiv Lochan J, Sr. Consultant – HPB & Liver Transplant Surgery; Dr. Aravind Sheshadri, Consultant – Integrated Liver Care; Dr. Apurva Pande, Consultant Hepatology and Dr. Naphene N, Consultant – Liver Surgery – performed a complex surgery to transplant the mother’s liver into the child and gave him a new lease of life.
Hailing from Kundapur, Karnataka, baby Abdullah had features of jaundice, including yellow-colored eyes, dark-colored urine soon after his birth and in the 5th month the child started presenting symptoms of liver failure. On further evaluation it was found that the baby had Biliary Atresia a congenital abnormality wherein the tract which is supposed to drain bile from liver into intestines was not formed. Hence, bile was being continuously accumulated in the child’s liver which eventually drained directly into blood leading to jaundice and later resulting in liver damage and chronic liver failure of the child. Children born with this condition require a surgery called Kasai’s procedure within the first few weeks of life.
Even though the child had undergone Kasai’s procedure at a local hospital when he was 5 months old, he did not improve and he developed progressive liver failure. He was then referred to Aster CMI Hospital for a liver transplant and it was performed when he was 7 months old. Her mother was the donor and both of them have now recovered well.
Explaining about the complications in the Abdullah’s liver transplant, Dr. Sonal Asthana, Lead Consultant – HPB & Liver Transplant Surgery, Aster CMI Hospital said: “Biliary atresia is a rare condition where bile ducts do not develop in some children. If not treated on time, the liver can fail and liver transplant is the only solution. The child’s mother had come forward to donate her liver, however, she did not have a compatible blood group. The child then had to undergo a special process to remove antibodies that were present in his liver and through this process his liver was made compatible with his mother.”
When Abdullah was referred to us he weighed only 5.8 kgs out of which 3kgs was the fluid accumulation in his body. This had made his breathing extremely laborious and the child was malnourished. It was a challenge for us to ensure the child’s safety during the surgery and ascertain that he recovers well during the post-operative care. While performing the surgery we took extreme care that the child does not lose much amount of blood and we are able to maintain his fluid balance. Our primary goal during the surgery was to ensure the safety of the child for those 10 hours.” said Dr. Arun V, Lead Consultant, Anesthesia and Critical Care, Aster CMI Hospital.
Sharing his views on the case, Dr. Chetan Ginigeri, Consultant – Department of Paediatrics & Neonatology, Aster CMI Hospital, said: “Liver transplant in children is a challenging task and more so in babies that are small, owing to malnourishment. In such small babies, the blood vessels are very small, their lungs are also not strong enough and their immunity is very low which further increases their risk of infection. Post the transplant the child was on ventilator for almost five weeks. As he was just 7 months old it took some time for him to recover. We also had to perform a tracheostomy on the child to enable him to breathe properly. As the child was unable to feed properly, we had put him on tube feeding. At the time of his admission, Abdullah weighed just 5.8 kgs, however, post recovery the child has now gained the optimum weight of 8 kgs. We are glad that we could provide this life-saving transplant to the child in the nick of the time.”
Thanking the doctor, Abdullah’s father Mr. Mohammed Riaz, said: “We are extremely thankful to the hospital and the team of expert doctors who provided the lifesaving transplant to our child. It is an unexplainable moment for us to see our child living a normal life. The hospital not only provided our child with optimum care but also put an earnest effort to ensure our son’s survival by helping us raise close to 35 lakhs. for the surgery. Without their support, our child would not have seen the light of the day. I express my heartfelt gratitude towards Aster CMI Hospital’s team. It is through their sincere efforts that our family is once again united.