Three-year-old gets new liver and working heart in one surgery

NEW DELHI: A three-year-old child, Divine, from Kenya recently underwent an open heart surgery and a liver transplant simultaneously at Sir Ganga Ram Hospital. Doctors claimed that this was a rare surgical feat and the only way the child could have been saved.

Dr Naimish Mehta, senior liver transplant surgeon at SGRH, said a large tumour in her liver and heart was not allowing enough blood to reach all parts of the body. “She was too sick for a surgery so we spent three months treating her to improve the nutritional status. Also, there was no previous example of simultaneous surgery on a child, so multiple brainstorming sessions went on to decide the course of action,” he added.

The doctor said normally they prefer to keep a gap between two major surgeries. But in this case that option wasn’t available as resection of the tumour in parts could have led to further spread. “Simultaneous surgery was the only option and we took a chance,” Dr Mehta explained.

The 15-hour surgery took place on June 20, which had nearly 40 medical personnel in attendance, doctors at SGRH said. First, Divine’s liver was dissected. Then, open heart surgery was done in the same operation theatre.

Dr Raja Joshi and his team stopped Divine’s heart and put her on heart-lung bypass machine, removed the whole right chamber of the heart and reconstructed it with a thin layer covering the heart (pericardium).

Meanwhile, in another OT, the liver transplant team led by Dr Mehta operated on the donor, the child’s father, Steven Obaro.

Once the child was weaned off the heart bypass machine, the new liver was transplanted.

Dr Sashank Pandey, senior liver transplant anaesthetist at SGRH, said the whole process was complex. “There was high risk of severe bleeding and hypotension. We maintained a strict vigil to pick up even minor changes,” he said.