A seven year old boy with rare ‘Wilson’s Disease’ and fighting for life, was transplanted with liver at Apollo Hospitals!
Hyderabad, February, 2017: Transplant Team at Apollo Hospitals performed liver transplant on a kid fighting for his life due to a genetic disorder – Wilson’s Disease and acute Liver failure, needing immediate medical intervention. The surgery was performed against all odds, using a slice from his mother’s liver.
Seven year old, Master T. Siddhartha Reddy, from Jeedimetla, was fighting for his life when he was first seen by Pediatric Hepatologist at Apollo Hospitals, Jubilee Hills, Dr Ramesh Srinivasan. Investigations revealed that he was suffering from a rare ailment called Wilson’s disease and Acute Liver Failure. Wilson’s disease is a genetic disorder in which copper builds up abnormally in the liver, eyes and brain. This overload of copper in the liver results in Liver failure. Often an otherwise apparently normal child can suffer with life threatening acute liver failure in this setting, warranting urgent liver transplantation, says Dr Ramesh Srinivasan. Majority of the people with the Wilson’s gene will be carriers of the gene and will not manifest the disease.
It all began in the last week of December when Siddhartha Reddy was found to have jaundice. A spell on fever on the New Year day made his condition worse and the already diseased liver gave up entirely. His blood clotting parameters became abnormal and the INR – a measure of the blood’s ability to form clots; climbed up to 6.7, the normal value should be 1. When the liver is diseased this value increases and such patients are at a very high risk of bleeding at multiple sites in the body, including the brain. The alarming parameters prompted Dr Srinivasan to involve the liver transplant team at Apollo Hospitals, Jubilee Hills, Hyderabad.
“When we saw the patient, he had very high bilirubin levels and his clotting parameters were so abnormal, we had to give him Fresh Frozen Plasma to keep his INR in the safe limit”, says Dr Manish Varma, Chief Liver Transplant Surgeon at Apollo Hospitals, Jubilee Hills.
Siddhartha was immediately listed in the super-urgent category with Jeevandan. However, the team of doctors knew that they could not wait indefinitely and the patient was fast running out of time. Thankfully, the boy’s mother, a homemaker, had a matching blood group and the liver was found to be fit for donation. The next challenge to overcome was thelong weekend to follow starting with Sankranti holiday, necessitating completion of all the tests and the medico-legal paperwork within a day. The entire team including the Social work department worked overtime to make this happen and the medical tests for the donor, the legal paperwork were done within the day and the hospital authorization committee was requested to give an expedited clearance for the operation.
The liver transplant took place in the early hours on 14th January, 2017 and was performed by a team led by Dr Manish C. Varma. However, for the transplant team challenges were far from over. The part of the liver that the mother donated, came with two very small blood vessels. The size of the vessels was 1 mm and 1.5 mm. “It is technically very challenging to join blood vessels that are small and the chances of they clotting again in the post-operative period was also very high, explained Dr. Manish Varma. Further the boy had to be given blood thinning medicines immediately after the transplant, which increases the risk of post-operative bleeding. How the highly experience Transplant team at Apollo Hospitals, weathering all the challenges and triumphantly completed the surgery. The boy has since recovered and has been discharged.