Dual live-donor transplant surgery conducted on 2-year-old – Times of India

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KOCHI: Grandmother donated her kidney and father donated his liver to save a two-year-old girl who weighed 7 kg, making her the smallest child in the world to have successfully undergone dual live-donor transplant.Doctors who performed the transplant at Aster Medcity said that the organ transplant manual states that a child should weigh at least 10kg for a transplant. Parvathy MS from Kodakara in Thrissur suffered from a rare congenital condition called primary hyperoxaluria type -1, in which the deficiency of a liver enzyme leads to abnormal spike in blood oxalate levels that permanently damage the kidneys.

“There is evidence of successful dual transplant being done on a child weighing 9 kg. But till date, no one has performed transplant on a child weighing 7 kg,” said Dr Mathew Jacob, consultant liver and abdominal multi-organ transplant surgeon, Aster Medcity.

However, the decision for transplant surgery was not immediate. “We wanted to wait till the child’s weight touched 10 kg. But when we realised that we would be risking her life if we waited, we discussed with the girl’s family and decided to go for transplant,” said Dr V Narayanan Unni, senior nephrologist, Aster Medcity.

Explaining their ordeal, Parvathy’s mother Saritha MS said that their daughter was first put on daily peritoneal dialysis when she was four months old. “The dialysis lasted for nearly 20 hours each day. After a year, she had to be put on ventilator and needed daily hemodialysis. But soon doctors said that transplant was the only option and they couldn’t wait longer,” said Saritha.

However, getting a donor, the baby’s size and age was not easy. Therefore, it was decided to take her grandmother’s kidney. But that had its own complications. While the adult kidney is nine and half to 11 cm, that of a child is 4 cm. Also almost half litre blood flows in the adult kidney in an hour, that’s the amount of blood flown in a child’s body. “The solution was to remove her damaged right kidney and place the new kidney. The blood volume in her kidney too had to be increased using highly specialised techniques,” added Dr Jacob.

“Post-transplant surgery in November 2016, the child was in the hospital for 51 days. She has recovered well and now weighs 10.4 kg,” said consultant paediatric intensivist Dr Rajappan Pillai.

Her grandmother, 53-yeear-old Sathi Raghavan added, “I told my son and daughter-in-law that I had to do this for my granddaughter. I am happy now as she able to move and breathe without much pain”.

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http://timesofindia.indiatimes.com/city/kochi/dual-live-donor-transplant-surgery-conducted-on-2-year-old/articleshow/57223567.cms

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