KOCHI: Shinumon M.R. and Saritha Shinu had been over the moon for three months since the birth of their daughter Parvathy.
However, the happiness of the couple from Kodakara in Thrissur district was short-lived as the toddler was diagnosed with a chronic kidney problem.
She had Primary Hyperoxaluria Type 1 — a very rare condition in which the deficiency of a liver enzyme called AGXT leads to an abnormal spike in blood Oxalate levels, which permanently damages kidney.
Doctors then zeroed in on a combined liver-kidney transplant, the only option available to save Paravathy’s life. Shinumon and Parvathy’s grandmother Sathy Raghavan volunteered to donate their liver and kidney respectively. In hindsight, finding donors was the easiest part.
What proved excruciating was the wait for the toddler to gain weight as the transplant surgery required her to gain at least 10 kg. However, she stopped gaining weight at 7 kg owing to multiple complications even as she was put on intense nutritional rehabilitation.
Watching her condition worsen by the day, doctors at Aster Medcity decided to go ahead with the surgery notwithstanding the high risk involved. The main challenge for the transplant surgery on the 20-month-old was her weight and size, for transplanting a disproportionate kidney runs the risk of compression of kidney veins leading to clots in the transplanted organ.
“The solution was to remove her damaged right kidney and use the space vacated by her liver to place the new kidney. The blood volume in her kidney too had to be increased using highly specialised perioperative anaesthetic techniques,” said Dr. Mathew Jacob, consultant liver and abdominal multi-organ transplant surgeon.
The 20-hour procedure got under way after two weeks of extensive planning and preparation in January. The procedure comprising three simultaneous surgeries — liver donor, kidney donor, and recipient — was successfully carried out by a team of surgeons and anaesthetists led by Suresh G. Nair. “This is the first time in the world that a dual live-donor-liver and kidney transplant surgery has been performed on such a small child,” the hospital said in a press release.
Parvathy recuperated at the hospital in 51 days post-surgery and started gaining weight.
