Staff Reporter

Portion of woman's liver transplanted into ailing son

Recipient passes the acute rejection phaseDonor's and recipient's livers expected to grow to required sizes in about three monthsBoth to be under observation for some more time

KOCHI: A portion of a woman's liver was cut out and transplanted into her 7-year-old son in a rare transplant surgery here, infusing new lease of life into the ailing child.

The 15-hour-long surgery at Lakeshore Hospital and Research Centre on December 5 last year involved a live donor unlike cadaver transplantation, where the organs of brain-dead patients are used.

Sreejith and his 30-year-old mother Maya underwent the surgery after a great deal of preparation on the part of the team of doctors. More than a month into the surgery, the doctors believe Sreejith has passed the acute rejection phase of the transplanted liver.

The donor and the recipient will be under observation for some more time with periodical check-ups. The donor's and the recipient's livers are expected to grow to the required sizes in about three months.

Addressing a press conference here on Monday, Philip Augustine, Medical Director of the hospital, and H. Ramesh, gastroenterology surgeon who led the team, emphasised on the coordination of the experts in various departments in making the surgery successful.

Explaining the process, Dr. Ramesh said the surgery had to take care of a number of small arteries and bile ducts while sewing the cut portion into the recipient's liver. This required the services of a vascular surgeon, plastic surgeon and anaesthetic expert to coordinate the procedures. A team of gastroenterologist and nephrologist provided support for the operation.

About one-third of the mother's liver was transplanted to the child. Sreejith, who first came to the hospital about two years ago, was diagnosed with end-stage liver disease caused by cirrhosis. Liver transplantation is the last resort for such cases.

Though the child was born normal, he developed jaundice two weeks after birth. He did not regain his health and his liver continued to deteriorate. As a result, his growth was stunted and he weighed only 12.5 kg. Doctors said he was not responding to any medication or other supportive treatments.

The recipient will be on drugs all through his life to help the body accommodate an external liver. The world is yet to know whether such medicines are required all through life, as the first such transplant took place in 1994 in Brazil and then in Tokyo, Dr. Ramesh said.

The cost of the surgery is about Rs.10 lakhs while that of cadaver transplant is about Rs.5 lakhs. In the U.S., such a surgery would cost anywhere between Rs. 75 lakhs and Rs. 2 crores.

Doctors Mohan Mathew, Head of Anaesthesia, Jose Tharayil, plastic surgeon, Ebby Abraham, nephrologist and Roy J. Mukkada, gastroenterologist were part of the team that performed the surgery.