Giving the little ones a new liver, a new life
View(s):It was a special day in Colombo recently when the parents of children, who have undergone liver transplants, gathered to show their gratitude to the team of doctors from the Liver Transplant and Hepato-biliary (HPB) Surgery Section of the Global Hospitals Group in India, headed by Prof. Mohamed Rela
By Kumudini Hettiarachchi
It is celebration time. Five children in party-wear are running around, some oblivious that their parents are here to celebrate life itself, their lives in fact. The parents have come to say a heartfelt thank-you to Prof. Mohamed Rela who heads the Liver Transplant and Hepato-biliary (HPB) Surgery Section of the Global Hospitals Group in India.
For, it is Prof. Rela and his team who have saved their children from the brink of death, as Sri Lanka still does not have the facilities to carry out this complex surgery.
His achievements include techniques for safe transplantation in neonates born with liver failure and performing a successful liver transplantation in the youngest child ever – a five-day-old – for which he is in the Guinness Book of World Records (2000 Edition)
The Indian team with Forte International & Pvt. Ltd. head M.F.A. Riyas (far left)
Not only has Prof. Rela performed a large number of liver transplantation and HPB surgeries on both adults and children from Sri Lanka but also an adult ‘swap’ liver transplantation surgery, a first in the region, on two patients from Kurunegala.
At the meeting in Colombo, although their faces show much disappointment when they are told that Prof. Rela was unable to make it due to pressing work, they jostle around his team to chat and laugh.
For Nimshi Shanoli, now about four years old, the itchiness pale-coloured stools and jaundice had begun in early infancy, says her father, Brian Rowlands from Enderamulla, Wattala. After being treated at the Lady Ridgeway Hospital for Children where the palliative Kasai procedure was performed on her, it was only temporary care that kept Nimshi going.
The need was a liver transplant as she was a victim of Biliary atresia and it was Brian himself who gave part of his liver to his little girl in May 2011, for Prof. Rela and his team to do the life-saving needful.
The other children at the function are nearly-two, Raziya from Negombo, three-year-old Pujani from Polonnaruwa and three-year-old Tharul from Kottawa, all of whom had got part of their mothers’ livers and one-year-old Dulnara from Meepe whose donor was her aunt.
The Indian team — brought to Sri Lanka by Forte International Pvt. Ltd., headed by M.F.A. Riyas — included Consultant Paediatric Hepatologist and Gastroentrologist, Dr. Naresh Shanmugam; Senior Consultant Transplantation and HPB Surgeon, Dr. Gomathy Narasimhan; and Senior Consultant Hepato-pancreatic-biliary and Liver Transplantation Surgeon Dr. Vivekanandan.
Razina with her parents
Prof. Rela in a message stressed that it is important for patients to undergo treatment as early as possible so that recovery is better and for physicians to identify early the conditions that warrant a transplant and refer them so that complications are less.
Dr. Shanmugam, meanwhile, pointed out that children have unique problems and at Global Hospitals the team ensures that it chooses the right transplant – auxiliary or split liver transplant which benefits children with end-stage liver diseases.
What is Biliary atresia
Biliary atresia is deadly. In this condition, some babies are born with the flow of bile from the liver to the gallbladder being blocked, which is usually followed by damage to the liver, that all-important organ linked to the digestive system, and cirrhosis (scarring) of the liver, MediScene understands
This occurs when the tubes or ducts carrying the bile are blocked or have not developed.
While in the bile are salts that help in the digestion of food in the small intestine, the bile ducts also channel the waste out of the liver, Dr. Sankalpa Marasinghe of the Castle Street Hospital says when contacted by MediScene.
Babies with this condition have jaundice (turning yellow), dark urine, a swollen spleen and pale or light coloured stools. They either gain no weight or do so very slowly, he says.
Although at the premier Lady Ridgeway Hospital for Children, Colombo the Kasai procedure to connect the liver to the small intestine, bypassing undeveloped bile ducts is performed, in many cases a liver transplant is essential.
Swap liver transplant, a first in the region
In the first-ever swap liver transplant performed by Prof. Rela and his team in India, it was textile businessman M.J.M. Nazeem (51) and leather goods businessman Mohamed Nazeer (48) who got a new lease of life.
Suffering from cirrhosis, the cause of which was unknown, when Mr. Nazeem needed an urgent liver transplant his wife, Fathima, had volunteered to donate a part of her liver. But her blood group was no match for his. It was then that they took another donor to Chennai, only to find that there were health issues and the transplant could not take place.
Coincidentally, around the same time Mr. Nazeer had also been at the same hospital in a critical condition – he too needed a liver and although his 21-year-old son, Zamrin, was willing to donate part of his, the blood groups did not match.
After discussion and agreement, there followed the 16-hour swap performed by Prof. Rela and his team in May 2011, with Nazeem getting part of Zamrin’s liver and Nazeer, part of Fathima’s liver.
A smiling and happy Nazeem and Fathima were also there on that day to say a heartfelt thank-you to the Indian doctors.
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