Sahaydri hospital recently performed a complex liver transplantation surgery on a 9 year old girl from Pune. The little girl had gone to Mumbai to spend time with her relatives where she complained of weakness and poor appetite. She was immediately taken to the local hospital where she was diagnosed with Jaundice. The parents immediately brought her back to Pune where she was under the care of a pediatrician.
After initial medical treatment her condition improved and she was discharged. However the condition of the girl soon deteriorated as she began feeling drowsy. Hence the parents immediately rushed her to the local hospital. On repeat test, bilirubin which was mildly increased previously had markedly risen to very high levels. The blood coagulation parameters were also beginning to become abnormal. Doctors continued the medical management and sought the opinion of the experienced gastroenterologist, who informed doctors that this is not a simple case of Hepatitis, it is a case of acute liver failure.
Immediately the liver transplant team of Sahyadri Hospital was consulted for an opinion. Liver experts at Sahyadri Hospital examined the girl and they also diagnosed that she had acute liver failure, but her condition did not meet criteria for liver transplantation. The health condition of the child was discussed in detail with the parents and treating doctors; they were also informed about the possibility that the child might require a liver transplant if her blood tests worsened.
As the management of such patients is best at centers where facilities for liver transplant if required are available, the child was soon shifted to Sahyadri Hospitals Deccan for further treatment.
After the 9 year old girl was shifted to Sahyadri Hospital, doctors regularly updated the progress of the child to her parents. But the liver functions worsened and it was clear from her blood reports that she needed a liver transplant. The parents were told about the child’s condition and the need for urgent liver transplantation. The Liver Transplant Surgery was performed by Sahyadri Hospitals’ Liver team comprising of Dr. Bipin Vibhute, Dr. Prashantha Rao & Dr. Manish Phatak.
While talking about this surgery, Liver Transplant Surgeon at Sahyadri Hospitals, Dr. Prashantha Rao said, “Patients with ALF are listed for cadaver liver transplant but due to poor availability of cadaver organs they don’t have a realistic chance of brain dead donor liver transplant. In them the realistic option is a live donor transplant only. Availability of expertise to manage patients with acute liver failure and keeping them as stable as possible till either live donor or cadaver donor for transplant is ready plays a vital role.
He further said, “In such surgeries, the expertise to do rapid evaluation for living donor liver transplant donor, to coordinate the logistics and do this surgery at a short notice plays an important role which is available at Sahyadri Hospitals. After the successful surgery of liver transplant, the girl child and her father both have recovered well, post one month of the transplant. Now liver functions of the child are normal, she is doing well and her father is back to work.”
Talking on need on Organ donation, ZTCC (Zonal Transplant Coordination Committee) coordinator Ms. Arati Gokhale remarked “ Increased awareness on Organ Donation in the community would in long run, help in increasing the availability of cadever organs so as to help tackling such situations”
The patient was listed with ZTCC for an urgent cadaver liver transplant, if a suitable brain dead donor was available. At the same time doctors also gave the option of live related donor liver transplant to the family. The family came forward for liver transplant and patient’s mother was evaluated as a prospective liver donor. As her mother’s liver was too fatty it could not be used for liver transplant surgery. However, the liver of her father was found to be fit for liver donation.
Dr. Bipin Vibhute, Liver Transplant Surgeon at Sahyadri Hospitals said,” This is a case of Pune’s First Living Donor Liver Transplant for Acute Liver Failure. There have been a few Living donor transplants in Pune, though for chronic liver diseases. In case of ALF (Acute Liver Failure), this was the first instance, in Pune and was a life-saving procedure.
He further said, “It is important to understand the difference between living donor and cadaveric donor liver transplant. Living donor means organ donated by a person who is alive; while cadaveric donor means organ donated by brain dead patient. “
Leading Gastroenterologist of the city, Dr. Nitin Pai, who referred this case said, “The girl child actually had a congential problem and it is important to recognize all jaundice are not simple viral disease. When I realized that this was a not a simple case of hepatitis or jaundice, but she was suffering from acute liver failure, I immediately consulted the liver expert team of Sahyadri Hospital, who have an extensive experience in Liver Transplants. After the successful liver transplant surgery, it is a proud moment for all of us that Pune based liver surgeons have helped save the life of this girl child.
Within a short span of 4 months, Sahyadri Hospitals’ Centre for Organ Transplants has performed 18 Liver Transplants successfully. With a dedicated liver transplant centre with 24/7 availability of experienced Liver Transplant Surgeons, Pune can now tackle such complex surgeries in the city itself.
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