New Delhi, August 2
A year-old Pakistani boy suffering from biliary atresia, underwent a successful liver transplant with liver donation from his maternal grandmother.

Syed Sheryar has given surgeons at Sir Ganga Ram Hospital a reason to smile, as he today became India's youngest liver recipient. Dr B.K. Roy, chairman of the board of management of the hospital told mediapersons here today that biliary atresia was a condition in which the bile duct did not develop. As a result there was no channel to carry the bile into the intestines.

Dr Roy said that surgeons decided to take up the case as Sir Ganga Ram Hospital had to its credit several successful liver transplants. Till date this year, the hospital had done 34 liver transplants of which 32 have been successful.

Senior liver transplant surgeon, Dr A.S. Soin, who operated on the Karachi boy on June 21 with his colleague Dr Subhash Gupta, told mediapersons that the boy's 45-year-old grandmother Nasreen volunteered to donate her liver. "It was a family decision because the mother, Saima, wanted to take care of the child after surgery." Talking of the challenging nature of the eight-hour-long surgery on the boy, Dr Soin explained that other than the age, the child had undergone an unsuccessful surgery in his home country when he was three months' old. "All organs tend to stick to each other inside. Those made the liver transplant surgery difficult. The second challenge was posed by the blockage of portal vein because of the advanced nature of the disease. The portal vein supplies 80 per cent of the blood to the liver. The new liver needed portal vein flow. We had to do a special technique called Cavo Portal Transposition. We had to put the Inferior Vena Cava blood into the liver," Dr Soin said.

The small size of the blood vessels and the bile duct was another challenge, as they had to be connected to the new liver suing magnifying loops and microscopic surgery, he added. "Despite the complex nature of the surgery, we were able to accomplish the task with minimal blood loss and without any blood transfusion. The grandmother underwent the surgery for six hours."

Dr Soin said that Sheryar first visited Ganga Ram Hospital with his parents in May after correspondence with him on e-mail. "They contacted me six months back giving a summary of his case history. Due to atresia, the boy had repeated infection, bleeding from the gastrointestinal tract and severe jaundice. He was grossly undernourished. He was too sick to undergo a transplant and weighed only 6 kg. He had to be built up through six weeks of nutritional care, psycho therapy and treatment for infections."

Surgeons, who gave Syed a new lease of life, are satisfied with the progress. "He was on a restricted diet till about 10 days back. Now, he is normal and playful," Dr Soin said.

He added that the boy was discharged on July 20.