5-yr-girl undergoes complex liver transplant; open heart

Doctors at Apollo Hospitals here have conducted a complex pediatric liver transplant and open heart surgery on a five-year-old girl with multiple health problems.
Dr Manish C Varma, Head of the Liver Transplant Department and Dr Girish Warrier, Consultant Pediatric Cardiac Surgeon at Apollo Hospitals, Jubilee Hills said the baby Parvati Rohra is suffering from a rare genetic disorder called Alagille Syndrome.
"It occurs with a frequency of 1:1,00,000 children and can impact the liver, heart, lungs, kidneys, bones among others," they said.
Compounding the problem was her weight of just about 10 kilograms. She was leading an extremely traumatic life, deprived of the normal childhood which kids of her age longed for.

On January 23, the doctors performed an open heart surgery for the cardiac defects and then a liver transplant with a live donor liver transplant was performed by using a part of her mother's liver.
The baby has since recovered and was discharged on February 7.

"A multi-disciplinary team of doctors at Apollo Hospitals created a medical history by performing a living donor liver transplant and an open heart surgery within a span of few hours on the baby girl with multiple health problems including advanced liver cirrhosis, congenital heart defects, severe growth retardation and rickets," they said.
"The task ahead was daunting for the team, especially since there is no precedence of treatment for such a complex case being attempted in medical history," Dr Varma said adding "it is one of the most complex surgery being done in the world and it is an achievement for the entire medical fraternity and will go down as a landmark in medical history."

Elaborating on the complexity of the case and the importance of clinical decision making, Dr Varma said, "all our investigations suggested that an open heart surgery would be able to achieve a cardiac function that would enable us to do the liver transplant. However, the most important thing was to identify the correct window of opportunity to do the liver transplant."
After this surgery, the baby will have a better growth curve and is likely to catch up on her growth over next 2 years. The rickets will get treated with vitamin D supplements which will now work due to a functioning liver, the doctors added.