Novel Liver Transplant Procedure Provides Toddler With Hope For A Life Without Pills

~ Doctors from Gleneagles Global Health City perform a liver transplant using a unique technique to help a toddler to live a normal life without any compromise

9th March 2020, Chennai: Gleneagles Global Health City (GGHC), a leading multi-speciality centre in Chennai successfully treated a young toddler for acute liver failure by performing an auxiliary liver transplant.

Sourav Sai, a 3-year old boy from Andhra Pradesh was discharged from Gleneagles Global Health City, Chennai, after one week of undergoing successful liver transplantation for acute liver failure – a life-threatening disease where a previously healthy liver suddenly stops functioning leading to jaundice, bleeding and coma. However, the doctors at GGHC performed this procedure with a unique difference where the doctors performed an auxiliary liver transplant- a technique where half of the child’s own liver was retained while transplanting a portion of his mother’s liver. The usual practice is to completely replace the recipient’s liver.

Dr. Joy Varghese, Director- Department of Hepatology & Transplant Hepatology noted that while auxiliary liver transplant is not a new procedure, very few centers have the know-how and technical expertise to perform this type of complex surgery. This technique is particularly useful in children as their liver regenerative capacity is good and life-long anti-rejection medications can be avoided.

Dr. Srinivas Reddy, Director – Department of Liver transplant & HPB Surgery who lead the surgical team explained that the decision to perform auxiliary transplant was made after careful analysis of multiple factors suggested potential for liver recovery. An auxiliary transplant is in fact, two major surgeries combined into one. Half of the child’s liver is first meticulously removed and then donated liver portion is transplanted in the space thus created. Both livers share a common blood supply and we have to ensure that both are well supplied with nutrients and oxygen at the end of the operation.

Dr. Selvakumaran Malleshwaran, HOD – Liver, HPB Anesthesia & Liver Intensive Care added that the child was critically ill at admission. He was started on organ support including ventilation before this novel surgery was considered in the emergency team meeting. After transplant, his mother’s liver will work as an immediate rescue treatment for the child and as a bridge to life until the child’s own liver slowly recovers its function.

Dr. Somasekhar, Clinical Lead – Pediatric Hepatology and Dr Rajanikanth Patcha V, Clinical Lead – Liver Transplant & HPB Surgery, concluded that the next 12-18 months is crucial as we closely monitor the child to see how his native liver recovers and regenerates. His anti-rejection medications will be carefully modified to encourage the child’s own liver to re-grow and gradually take over the life supporting functions from the mother’s liver. Full recovery of the native liver is seen in upto 80% of cases, which means this little one will not need to take life-long immunosuppressive medications.

Praising the team on the accomplishment of the case, Dr Alok Khullar, CEO, Gleneagles Global Health City, Chennai said, “Performing an auxiliary liver transplantation at an early stage can avoid complications. In this particular case of a 3 year old child, it was extremely crucial to perform the surgery to ensure that the liver of the patient regenerates and the need for medications can be reduced. The doctors prioritised the quality of toddler’s life in their treatment plan which helped them to approach the transplant in a unique way. GGHC always strives to help its patients to lead a normal life by helping them with the advanced medical solutions.”