Complex ICU Liver-support therapy
at Apollo Children’s Hospitals Saved a Three-Year-Oldfrom Fulminant Liver
Failure without a transplant
While Liver transplant remains as the
epitome of the many momentous ways that can guarantee survival ina patient with
liver failure, Specialist at Apollo Children’s Hospitals, Chennai saved a three-year-old boy, Radhesh from
Fulminant Liver Failure without a liver transplant.
Children with sudden catastrophic liver
failure (also called fulminant liver failure) do not have enough time to wait
for a favorable donor. In most of the cases, they suffer from malignant brain
swelling, torrential bleeding, or galloping infections. If a liver transplant
is not performed within the stipulated time gap of a day or two patients might
lose their life waiting for a suitable liver for transplantation.
Recently, Three-year-old Radhesh
developed a sudden fever, which almost took his life. Hailing from a middle
class background his parents were distressed by their son’s deteriorating health. When he was brought to Apollo
Children’s Hospital Emergency Room for treatment,Dr Priyavarthini, Senior Consultant in the PICU , diagnosed him
with Fulminant Liver Failure.
Dr Suchitra Ranjit, Senior Consultant, Chief of Pediatric ICU, Dr Vasanth Kumar, Dr Priyavarthini and Dr Rajeswari N and team of doctors at Apollo
Children’s Hospital were worried for his life and sought the advice of
the liver-transport team and he was listed for emergency liver transplant. Meanwhile,the
team decided to try out all possible ways to bring back the child’s condition to normalcy. The child was under the complex ICU
Liver-Support Therapy that serves mainly as a bridge to support life until a liver
transplant is completed. The ICU Liver Support Therapy supports the entire
body-systemand perform the functions of the liver until the liver is totally recovered.
The liver transplant team including Dr
Elankumaran, Liver Transplant Surgeon, Apollo Children's Hospitalsscreened the
patient’s parents and family membersto enable a living donor
transplant, unfortunately, none had a suitable liver.
Speaking about the case Dr Suchitra Ranjit, Senior Consultant,
Chief of Pediatric ICU,Apollo Children’s Hospital, said, “Within 24hrs, he worsened further and his life was in a
delicate balance. Liver failure has detrimental effects on many important
organs, including the brain, kidney, circulation, and blood clotting: he
quickly became deeply comatose with a dangerously swollen brain on CT scan, his
urine output stopped, and his blood clotting mechanisms failed with very high
risk of hemorrhage. We were worried that he would lose his life waiting for a
suitable liver, and he was listed for a super-urgent cadaveric liver transplant
so that the first available O+ liver in the whole of Tamil Nadu would be rushed
for Radhesh.The patient’s story went viral on a Crowd-funding
site and sufficient money was gathered for the procedure, while the patient was
still awaiting the organ.”
She also added, “Our aim was to sustain Radhesh until a liver was made available.
We placed him on complete life-support utilizing the same high-end technology
that is available in the best liver-units across the world. He was ventilated,
placed on chemically-induced coma, and provided Continuous Renal Replacement
Therapy (CRRT – a technologically advanced form of
dialysis) and also a dose of daily plasma-exchange (a form of blood
purification therapy), in addition to continuous brain monitoring and
circulatory support. These therapies are temporary, highly risky, and invasive
and meant as a bridge to transplant. No donor was suitable- and miraculously
Radhesh pulled off the most unlikely and marvelous feat and started functioning
normally.”
Radhesh’s liver which was totally necrotic (destroyed) started
showing recovery. As his liver recovered his brain swelling decreased, and
kidney function improved. All the tests started to improve, andon 20April2019
(nine days after admission), he was removed from ventilator and other
life-support systems were discontinued.
10 days after discharge, Radhesh is
playing cricket with his brother and sister and looking forward to joining school.
This was an ordinary family of the street with no-one to speak for them, and we
at Apollo Childrens Hospital could offer the child and his family the full
might of Apollo’s formidable technology and support. Apollo’s motto is to touch lives, and this little life was truly
touched with fantastic help from powers above.
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