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Pak boy undergoes bloodless liver transplant in Delhi
Tripti Nath
Tribune News Service

New Delhi, April 28
Safi Khan, a four-year-old Pakistani boy suffering from congenital liver disease is assured of a better quality of life after a successful liver transplant without any blood transfusion at Sir Ganga Ram Hospital here.

This is the first time in India that a liver transplant has been done using bloodless technique. This is also the first time that the liver transplant unit in the hospital has done a liver transplant on a Pakistani child.

A ten-member team of surgeons and anaesthetists operated on the recipient and the donor simultaneously early this month.

Dr Soin told TNS that he got the boy’s reference on his website (www.livertransplantindia.com). When the Lahore-based boy came to Sir Ganga Ram Hospital with his mother, Anila, he was diagnosed as suffering from PFIC (Progressive Familial Intrahepatic Cholestasis Type III). He was suffering from jaundice since he was eight months old and his liver had become cirrhiotic.

Dr Soin said the boy’s mother volunteered to donate a part of her liver for transplant but she was not a suitable candidate as she had earlier undergone gall bladder and bile duct surgery. ``We then asked them to see if they could find another donor in the family. Then, the boy’s young uncle (chacha), Naveed came forward.’’

Dr Subhash Gupta said the experience of the team and use of devices that check coagulation abnormalities in real time enabled them achieve their goal. ``We minimised blood loss to such an extent that the boy did not need any blood transfusion. The blood loss was hardly 150 ml. In liver transplant surgery, we requisition 20 units of blood but we may end up using four to six units. In this case, we used Thromboelastograph, a machine used to know how blood is clotting and Argon Beam Coagulator used to cut through the tissue with minimum blood loss.’’

According to Dr Soin, the bloodless surgery made the post operative course simple. ``We were able to put the patient off the ventilator soon after the surgery. The boy will be discharged within two to three days.’’

Dr Neelam Moham, Paediatriac gastroenteroligist and hepatologist told TNS that the boy came to the hospital and was admitted for a week in mid-February. ``All we knew at that time was that he had itching, jaundice and poor quality of life. We sent slides of his liver biopsy to King’s College, London for some special staining and a sample of his blood for gene analysis. This confirmed that the boy had Progressive Familial Intrahepatic Cholestasis Type III. Once the diagnosis was confirmed, it was necessary to prepare the child.

We did this by clay modelling and drawings and Safi really cooperated with us. He never bothered anybody over injection shots.’’

Dr Mohan said Safi will now be put under immuno suppressants. ``Depending on his condition, we will reduce the dosage three month onward. He will soon be able to lead a normal life.’’

Dr Soin said the liver transplant at Sir Ganga Ram costs Rs 15 lakh but in this case, the hospital brought down the cost to Rs 12 lakh. ``The boy comes from a middle class family. His father, Raees Khan works in the Middle East and raised funds by appealing to Indian expatriates who cross-checked details about his medical condition with us.’’

Sir Ganga Ram Hospital set up the liver transplant unit three years ago. In the initial two years, the hospital performed nine liver transplants of which five were successful. Dr Soin said of the12 liver transplants done last year, 10 were successful.’’