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Mother-daughter liver transplant saga

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BONDING ACT: After the surgery, both Preeti Ishwar and Meenu Nanwani are healthy and cheerful. -- PHOTO BY SPECIAL ARRANGEMENT
BONDING ACT: After the surgery, both Preeti Ishwar and Meenu Nanwani are healthy and cheerful. -- PHOTO BY SPECIAL ARRANGEMENT

Ramya Kannan

In an inspiring tale of three cities, a Chennai-based mother makes a life-saving gift to her daughter

CHENNAI: A part of Preeti Ishwar's liver lives outside of her, a good four-and-a-half hour plane ride away from Chennai, in Jakarta, Indonesia. A part she fought to give away, so that her daughter could live. In Jakarta, Preeti's liver rests securely on the right side of her daughter Meenu Nanwani's upper abdomen, regenerating to form a whole liver, energetically performing the broad range of its normal functions. And Preeti? She is fine: her liver too is whole and functional now.

But one year ago, when Preeti first offered to donate her liver, she did not know the part of the liver left in her would bounce back again. In fact, her only thought then was to save her child, at any cost: "I cannot see my daughter die." Meenu Nanwani had hepatitis and her liver had failed. As the principal of the Singapore International School, in Jakarta, Meenu lived a healthy life until February 2005, when what seemed to be an attack of jaundice led to hospitalisation and steady overall deterioration of health. Her husband Kamal rushed her to Singapore and took her to the National University Hospital, where it was discovered that Meenu had acute liver failure and needed transplant surgery. A cadaveric liver (harvested from individuals who have died) was ruled out, as Meenu was not a Singapore national. The only life-saving option was to find a matching live donor.

Kamal himself and Meenu's father and sister were ruled out because they were of a different blood group. That left only Preeti, who doctors thought was too old to donate. Kamal and Meenu's uncle Srinivas Nammalwar scoured both countries for a live donor, with no success.

Meanwhile, Preeti was constantly badgering Singapore's most famous living donor liver transplant surgeon, K. C. Tan, and his team to allow her to donate her liver. The great man resisted because he thought at 59, Preeti was too old to take a risk - but capitulated when it seemed as if time was running out for Meenu. They ran tests for the mother and discovered that not only was she a perfect match for her daughter but also that she was in the pink of health. Meenu would be the oldest living donor Singapore had ever seen.

"I didn't know what I was getting into then. I just wanted to save my daughter," Preeti says, in retrospect. And it turned out that the least of her troubles was to answer the questions of the Ethics Committee that had to clear her as a donor. "They asked me if I was Meenu's real mother, if my son-in-law was paying me to do this and if my husband had sufficient income to support me. They are very strict in Singapore about checking each donor, but I had to summon up strength to sit through that session."

On June 15, in a procedure lasting 12 hours, Dr. Tan's team cut the right lobe of Preeti's donor liver and transplanted it into the recipient. The results, for Meenu, were dramatic. Meenu recovered in two weeks, was back on her feet and even began taking care of her mother, who was still recovering. Though Preeti was also timed to be up and about at roughly the same time, complications occurred one after the other, and various procedures had to be performed on her. It was in July, nearly a month after the first surgery, that she turned around and thenceforth recovery was steady.

In August 2005, Preeti and Meenu left Singapore, one to fly east, the other to fly west, both rested, their livers kick-started into action. "It is not so much my tale as the possibilities of live liver transplant that I want to shout over the rooftops," Preeti says, back to her routine, which includes fitness schedules, in Chennai. "I am glad that I could donate for my daughter. But it should be possible for all, especially in India. People should know that donating a part of the liver will not kill them. The liver regenerates so fast - my liver is now 100 per cent, both in size and function. And Meenu's recovery is faster still. She has even put on weight," she says, her voice bursting with a mother's pride and teasing, her happiness sweetening the bitter taste of bile.

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