Gleneagles Global Hospitals Hyderabad saves children from end-stage liver disease

The recipients were not only transplanted for very severe, advanced end-stage liver disease, but also had unique physical attributes that had to be kept in mind

The Gleneagles Global Hospitals Hyderabad shares the success story of two paediatric transplants performed in recent weeks.

Master Sai Ganesh, five years old young boy from Vijayanagaram, reported to the hospital in the month of June 2018, with severe liver disease. The boy had been taken to other transplant centers in the state and in South India, but was not accepted for liver transplantation on account of very poor health status, as well as the presence of situsinversus. This condition is congenital, wherein organs in the human body are in a ‘mirror-image’ location– that is organs normally located on the right side of the body are located on the left, and vice versa.

The surgery was an extremely challenging one, but the surgical team comprising of lead surgeons Dr K Venogopal and Dr Balbir Singh successfully implanted a part of the liver taken from the child’s father into the child, after removing the diseased liver. The anesthetic management of the child was equally challenging, but the transplant anesthesia team comprising of Dr Ravi Chandra, Dr Mohan and Dr Gopi were equal to the task and carried out the surgery and post-operative care of the child well.

Baby Selam Devi, an eight years old girl from Khammam, had been suffering from chronic cholestatic liver disease for many months before she was reported to Gleneagles Global Hospitals. She had been evaluated at other centers in the state, but was not considered for transplantation on account of being ‘too sick’.

At Gleneagles Global Hospitals the patient was optimised medically, and then listed for transplant. However, a block came in the form of non-compatibility of blood group between donor (mother, blood group A1) and the recipient (blood group O). Traditionally, patients with blood group O can receive organs only from identical blood group donors. When such incompatible solid organ transplants are performed beyond infancy, the graft loss rates are extremely high, unless the level of immunosuppression (medicines given to suppress the recipient’s immune system, so that it would not turn hostile against the graft) is escalated substantially.

Baby Selam was not an ideal candidate for this approach, as she was too sick and her blood parameters were not suitable for heightened immunosuppression. This situation was managed by the treating team comprising of Dr Prashanth Bachina from Rainbow Hospitals Hyderabad and Dr Prashanth Shinde from Gleneagles Global Hospitals, Hyderabad. They used a novel strategy of immunosuppression to thwart graft rejection in the early post-operative period.

The experience of these two paediatric transplants has once again proven that with planning and team approach, the most challenging clinical scenarios can also be turned to success stories.