GLENEAGLES GLOBAL HEALTH CITY PERFORMS INDIA’S FIRST SUCCESSFUL PEDIATRIC COMBINED LIVING DONOR LIVER AND KIDNEY TRANSPLANT
FOR A RARE GENETIC LIVER DISORDER
12-year-old boy with rare liver disease undergoes successful multi-organ transplant making him the 2nd case in the world and 1st in the country
Gleneagles Global Health City (GGHC),
a
leading multi-organ transplant centre in Asia, successfully performed
India’s first live donor liver and kidney transplant on a 12-year-old
who was suffering
from a rare genetic disorder – Primary Hyperoxaluria type 2.
Master Anish*, a 12-year-old, was referred from Bangalore with renal failure and had been on dialysis three times a week. Doctors in Bangalore had diagnosed him with a rare genetic disorder called Primary Hyperoxaluria (PH) type- II, which is a liver condition that results in accumulation of oxalate in the kidneys, heart and bones and other organ systems of the body. As the disease is primarily based in the liver, these patients need combined liver and kidney transplantation for cure which is a major undertaking, especially in a child.
Across
the world, there are only two reported cases of this treatment and this
has never been reported from Asia. The family
was apprehensive about two major surgeries at one time and contacted
GGHC’s liver transplant team for a second opinion and decided to get
treatment at GGHC, Chennai.
The pioneering transplant was led by
a team of doctors comprising of Dr Joy Varghese,
Director - Hepatology & Transplant Hepatology, Dr Somashekara,
Consultant Paediatric Hepatologist and Liver Transplant Physician, Dr Mettu
Srinivas Reddy, Director, Liver transplantation & Hepatobiliary Surgery,
Dr Rajanikanth Patcha, Clinical Lead - Liver Transplantation & Hepatobiliary Surgery, Dr Selvakumar Malleeswaran,
HOD – Liver Anaesthesia & Critical care, Dr Perumal Karnan, HOD - Paediatric Intensive care,
Dr Mohan Babu,
Consultant, Pediatric Intensive Care, Dr K Muruganandham,
HOD &
Senior Consultant – Urology and Renal Transplantation & Dr P Muthukumar,
Senior Consultant – Nephrology & Renal Transplant Physician.
Elaborating about the case,
Dr Somashekara, Consultant Paediatric Hepatologist and Liver transplant Physician, Glenealges Global Health City, Chennai,
said, “It was a great challenge addressing this paediatric case as
there are no proven studies reported elsewhere. This successful
multi-organ transplant gives hope for many such patients across the
globe.”
Speaking about the surgery, Dr Mettu Srinivas Reddy, Director of Liver Transplantation & Hepatobiliary Surgery, Glenealges Global Health City, Chennai, said,
“Combined live donor liver & kidney transplant surgery involves a
team of over 20 liver & renal transplant surgeons. It is like a
large symphony orchestra where the timing of the two donor operations
and the child’s double transplant surgery was carefully
coordinated so that the out-of-body time of both the donated partial
liver and kidney was kept to a minimum while ensuring both organs are
safely transplanted.”
The Renal transplant team lead by
Dr P Muthukumar, Senior Consultant – Nephrology & Renal Transplant Physician
and Dr K Muruganandham,
HOD &
Senior Consultant – Urology and Renal Transplantation,
Gleneagles Global Health City, Chennai
added, “On arrival, the patient was dependent on
dialysis 5 times a week and had severe anemia. As high levels of oxalate
can increase heart complications during such major surgery, the child
was put on a high intensity dialysis therapy
to prepare him for the surgery. All blood transfusions had to be timed
during dialysis to prevent fluid overload. Kidney transplant in children
is complicated as a full adult kidney should be placed in the pelvis of
the child. His mother was tested to make
sure that she doesn’t have the same genetic problem as Anish*. We
proceeded with her as a donor after extensive multidisciplinary
discussion as the safety of the donor is always paramount in living
donor transplantation.”
Dr Karnan, Head of Paediatric Intensive care,
Gleneagles Global Health City, Chennai
said,”Varun
was closely monitored in the liver intensive care after surgery.
Dialysis was continued for 3 more days after surgery
to control the levels of oxalate in his blood. Both organs also need
careful monitoring for rejection so that treatment can be started
immediately. He was discharged from the hospital on the 16th
day post-surgery and is doing very well. Both his
mother who donated the kidney and his aunt who donated part of her
liver recovered completely and were discharged within a week after
surgery.”
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