- Baby Ram, is the smallest
baby at 6.5 kgs in Maharashtra to undergo a liver transplant after being
diagnosed with biliary atresia.
- Dr. Darius F
Mirza with his team of surgeons performed the risky liver transplant on
the critically ill one-year-old baby.
- The liver
transplant was entirely funded by charitable donations, CSR grant from the
hospital management and crowd-funding initiatives.
Baby Ram was
diagnosed with a rare congenital condition called biliary
atresia, the disease was later found to have progressed to advanced
liver cirrhosis within months of his birth. In this rare condition,
the baby’s common bile duct (a duct between the liver and the small
intestine) is blocked or absent.
Dr. Darius F
Mirza and his team of surgeons at the Apollo Hospitals, Navi Mumbai performed a
liver transplant on the critically ill one-year-old baby in February, 2018.
He is by far the smallest baby at 6.5 kg to have undergone a liver transplant
in Maharashtra. The
baby’s donor was his loving aunt – Divya who
donated a part of her liver.
‘Liver transplant is an increasingly successful treatment option for biliary atresia. Children with biliary atresia have survived well into adulthood. Survival after liver transplant has increased to encouraging levels in the recent years.’
surgical intervention- Kasai portoenterostomy (KPE) surgery is
critical to prevent irreversible damage. However, in baby
Ram’s case the irreversible damage was already done, the liver failed to
respond, and hence
a liver transplant was the
only surgical option left.
The baby’s parents
had to search high and low for a team of surgeons who could successfully do the liver transplantation. The cost of treatment was also a major concern for the family.
Dr. Darius F
Mirza, Head, Liver Transplant, Apollo Hospitals, Navi Mumbai spoke to Medindia
exclusively about the biliary atresia and Ram’s liver transplant operation.
what state had the baby Ram come to you?
Ans: Baby Ram was
quite jaundiced, malnourished and weak when he came to see us. He was also
suffering from multiple infections.
Q: Is Kasai portoenterostomy (KPE) surgery
which is considered to be the first-line treatment for biliary
atresia – not applicable for baby Ram?
did undergo a Kasai portoenterostomy (KPE). This operation is
successful in between 30 and 60 percent of patients. Sadly he was one of the
you expect a normal growth of the baby?
Ans: Yes, and
most of these children experience to catch up growth after their liver
Q: How long would the baby have
survived without the surgery?
between 3 and 12 months.
baby Ram be needing any more surgeries in the future?
us what was the difficult part of the surgery?
Ans: Dealing with
the small size and removing the old diseased liver due to the extensive
adhesions and dilated blood vessels as a consequence of his previous surgery
and advanced liver disease.
Q: Will the baby need a life-time of follow
you think there is a need to create a national screening program using stool
color cards, as part of standard care in the neonates to raise awareness among
young pediatricians and parents?
Ans: The main
message is jaundice that persists after birth is abnormal and
needs careful investigation. This is completely different from the
self-limiting transient jaundice that many small babies experience soon after
us without crowdfunding would this miracle be possible?
Ans: We needed a
combination of individual generous donations and the crowd-funding
platform, along with a CSR grant from the hospital management, to allow us to
achieve successful transplantation.
in organ transplant techniques have led to greater availability of livers for
transplantation in children. In the past, livers of small children would only be
preferred for transplants in children, however now
revolutionary surgical techniques have allowed the option of “reduced
size” or “split liver” transplants. In these “split
liver” transplants, a piece of an adult liver can be used for
transplantation in a child. Parents or close relatives of the children are
eligible for “split liver” transplants in children.
Souls go to heavens; organs don’t. So let’s all donate our organs and save lives.