A liver transplant is a life saving operation. Patients undergoing a liver transplant are often close to death when they have the operation. The donor makes a major decision to undergo an operation to save the patient's life. These are the stories of some such patients and donors. The names have been replaced with initials to protect their privacy but many of these patients and donors have expressed their willingness to speak to prospective patients and donors about their experience. This can be arranged through our office.
The Young Girl with Auto-immune Hepatitis
Ms HAS was diagnosed with auto-immune hepatitis at the age of 14 years. This is a disease in which the body makes antibodies which damage the liver. The disease is treated with steroids and other drugs to suppress this abnormal immune activity.
She was on medical treatment and her disease had a waxing and waning course. Despite her illness she continued with her studies and joined engineering college.
By the age of 21 her liver was failing. She had fluid in her abdomen which had to be drained repeatedly and she had become so weak that she could not get out of bed on her own. She could not speak above a whisper and it was difficult to make out what she was saying.
Her father consulted transplant surgeons from Germany, Turkey etc. They all said she was too sick to tolerate a liver transplant. Finally, as a last resort he came to India with the patients' reports. He requested one of the surgeons at Sir Ganga Ram Hospital to travel to Jordan and evaluate her there and decide whether she could tolerate a transplant. He himself volunteered to be the donor. He did not want to bring her to India without offering her hope of cure. To come here and to be told that she could not have a transplant would have been heart-breaking.
Dr Vinay Kumaran went to Jordan as a guest of the patient's father and evaluated her. At first sight things did not look good. She was weak and emaciated. She could not even swallow properly and was forced to spit out her saliva constantly. She could not speak above a barely audible whisper. He was, however, impressed by her will to fight the disease and after discussions with the rest of the team he gave her father an estimated 80% chance of success (the normal success rate for an elective transplant is 90-95%). He was overjoyed (later he said that he would have accepted even a 50% chance of success.
They came to Sir Ganga Ram Hospital in August 2010. After a detailed evaluation of patient and donor, the transplant was done on 2nd September. The concern was whether she would be strong enough to come off the ventilator after the transplant. She recovered wonderfully, impressing everyone with her will-power.
She is now back to a normal life, 3 months after the transplant.
The Child with Fulminant Hepatic Failure
SC was a normal, healthy, bright 9 year old girl when she developed jaundice and fever. She was initially treated medically as a case of viral hepatitis but the jaundice continued to increase and when she became drowsy she was referred to Sir Ganga Ram Hospital. She was evaluated by Dr Nishant Wadhwa, the Pediatric Hepatologist and it soon became clear that she was in fulminant hepatic failure and would almost certainly die without a liver transplant. By the time she reached the hospital she was in a deep coma and she had to be put on a ventilator.
The family was told about the need for an emergency liver transplant. The parents blood groups were not compatible with the childs. The maternal uncle offered to donate for the girl. The cost of the transplant was also a factor but the family rallied round and collected as much money as they could and the hospital agreed to subsidise the transplant as a special case.
The concern by now was that the swelling of the brain due to liver failure may have caused irreversible brain damage. However, a momentary opening of her eyes indicated that her brain was preserved and we decided to go ahead with the transplant.
By now she was very sick. The blood pressure was low and needed repeated boluses of noradrenaline to maintain it. Dr Naimish Mehta and Dr Vibha Varma did a rapid hepatectomy (removal of the liver). After the toxic dead liver was removed, she stabilized. Meanwhile, Dr Kumaran split the donor's liver and removed the left side for transplant.
The liver transplant was uneventful. She made a slow recovery, requiring 9 days to get off the ventilator. Her subsequent recovery was very rapid and now, more than 3 months after the transplant she is back to a normal life.