Iraqi woman with rare syndrome undergoes complex surgery

A 21-year-old Iraqi woman, who suffered from a rare genetic condition, got a fresh lease of life after undergoing a surgery at a hospital in neighbouring Gurgaon.
Doctors had diagnosed the woman with a Budd-Chiari Syndrome, a condition where blood clots completely or partially blocks the blood flow to the liver in an individual. Very few cases of this syndrome have been reported worldwide so far, the Fortis Memorial Research Institute (FMRI) said today.
"It all started somewhere in the year 2014, with initial symptoms of turning pale, then yellow with severe pain shooting down the left shoulder to her arm soon developed into swelling in her limbs and abdomen," the patient, Bnar Satar Mala, was quoted as saying in a statement by the hospital.

She had given up hopes of survival and then travelled to India. The life-saving surgery at FMRI was conducted on December 28.
"I would feel nauseous at the mention of food, I could barely eat and often throw up soon after... No doctor wanted to take the risk of operating on me, at best, a stent was put inside my liver to drain the fluid out," she recalled.
Due to the blockage in the hepatic vein which obstructed the outflow, her liver was gradually "dying", doctors at FMRI said. A team of doctors lead by Dr Vivek Vij, Director, Liver Transplant, FMRI conducted the extremely complex surgery.

"By the time Mala reached FMRI, her liver was completely black and shrunken, requiring urgent transplant in order to save her life. Her brother, 27-year-old Bzar, matched for a donor in her case. All necessary tests were done and Mala underwent the transplant on December 28," Vij said.
"The affected liver was removed and a part of the liver was taken from her brother and transplanted in the patient. In this case, the challenge was to suture the liver directly to the heart as the patient's native IVC (inferior vena cava) was completely blocked. In order to suture the liver as close to the heart as possible, the heart had to be pulled down into the abdominal cavity.

"We decided not to open the recipient's chest and instead pulled the heart down through a narrow gap made in the diaphragm separating the chest and the abdomen. By doing this, we significantly reduced the risk of any infection which could have occurred due to a large opening in the chest," Vij said.