Domino effect: Two toddlers cured with one donor liver

Two children from the city,Shaurya,22 months,and two-year-old Siya,have become the world’s youngest and the country’s first beneficiaries of an organ transplant procedure known as the ‘domino’ or sequential liver transplant.

Written by Express News Service | New Delhi | Published:February 20, 2009 12:56 am

Two children from the city,Shaurya,22 months,and two-year-old Siya,have become the world’s youngest and the country’s first beneficiaries of an organ transplant procedure known as the ‘domino’ or sequential liver transplant.

This unique procedure involved one single donor liver. Shaurya’s aunt Mukta donated 20 per cent of her liver to Shaurya to cure a rare condition Shaurya was battling — the Maple Syrup Urine Disorder or MSUD.

His liver was then transplanted into Siya,who is undergoing treatment for terminal liver failure. Her condition is known as Langerhan’s Cell Histiocytosis (LCH).

Due to this procedure,Shaurya has been cured of MSUD,while things are looking better for Siya. The operations,at one go,took 16 hours on January 31. Twenty surgeons performed the marathon surgeries at the Sir Ganga Ram Hospital,the first in the country to perform a ‘domino’ transplant. All three are doing well and have been discharged.

Shaurya’s condition was from birth. MSUD is caused when there is a build-up of amino acids in the body due to an absent enzyme.

The high level of acids in urine makes it smell like sugar and hence the name Maple Syrup Urine Disease. Shaurya’s father Prashant Verma said: “He needed a specialised diet,devoid of amino acids. But the diet would have only shrunk as he grew older — therefore,the operation.”

Siya’s condition affects multiple organs and leads to liver failure. Her mother Swati Thakur said: “She was on chemotherapy,but the disease continued to spread. Her liver was irreversibly damaged.”

Chief surgeon of liver transplants at the hospital,Dr A S Soin,said they were in touch with medical centres abroad which had been successful in sequential transplant. “We wanted to be absolutely sure and hence consulted centres in Pittsburgh. We also checked with them the age of former liver recipients. The youngest till now had been eight. ‘Domino’ transplants are rare because there are very few conditions in which you can conduct sequential transplant without passing on the disease to the donor who receives the full organ. In this case,MSUD happens to be among those diseases which does not pass on.”

According to doctors,this procedure has made Shaurya the country’s first and the world’s youngest recipient of a living donor liver transplant for MSUD. Siya is also the country’s first and the world’s youngest participant in the ‘domino’ liver transplant.

Chief paediatric hepatologist Neelam Mohan also ruled out any future complications. She said: “They will be normal in three months. “We shall keep an eye on them to check if the disease relapses,” she added.

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