Amid Covid-19 emergency, Aster doctors rise to occasion to save six kids plagued by chronic liver ailments

Bengaluru: The onslaught unleashed by the coronavirus pandemic has taken away the attention of doctors worldwide from other health concerns.

However, for six children, waiting was not an option as without a critical liver transplant, survival would be difficult. In the midst of the Covid-19 pandemic and consequent lockdown, the Integrated Liver Care team at Aster RV Hospital went an extra mile to ensure that the children received life-saving liver transplants which have been 100% successful.

All the six children were between the ages of 3-10 years and were suffering from end-stage liver disease. In addition to the ILC team's support, guidance and assurance, hospital subsidy towards the transplant, corporate social responsibility funding from industry and crowd funding came as a ray of hope for the families of the children during the pandemic. Funds to the tune of Rs 20 lakh through CSR, Rs 25 lakh by way of subsidy from the hospital and a cumulative Rs 75 lakh was raised through crowdfunding to help support the six families.

Dr Rajiv Lochan, Lead Consultant, HPB and Transplant Surgeon, Aster RV Hospital, said "Limited scope of travel, unavailability of deceased donor organ donations since the start of the pandemic and logistical challenges with respect to the arrangement of funds were some of the factors which made it difficult for patients to undergo critical organ transplantation surgeries. For patients afflicted with liver disease or acute liver issues, delaying a transplant can have a direct impact on their life expectancy and is very risky. However, we had to balance the risk of the COVID -19 infection with the benefit of the treatment and this involved complex logistics which the team was able to organize."

Organ donation and transplantation witnessed a significant drop since the start of the pandemic as all the hospital ICUs were fully occupied and there were regulatory changes which affected organ donation too.

"The option of living donor transplants helped us to perform these emergency surgeries for the little ones. Our Affordable Liver Transplant model is an innovative means of ensuring that life-saving transplants are made affordable for all. It is an absolute joy to see them recover well and get back on their feet. The children and their donors and families are the heroes of the pandemic and show us that the human spirit can overcome the most difficult of trials and tribulations," Lochan added.

"We were scared when we got to know about our daughter's condition and we wanted to do the transplant for her as soon as possible. I was an eligible donor and we were prepared for the surgery. Then the pandemic hit and we did not know what to do. The doctors at Aster RV were very calm and explained things to me clearly. We finally underwent the surgery in April 2020 and now we are completely fine," said the mother of Bhuvi Darshka, one of the youngest children who underwent liver transplant in Bangalore last year.

The doctors say that living donor liver transplant in children is one of the most challenging treatments that modern medicine is able to offer. The complex physiology of children, the technical challenges of the operation, care of the living liver donor all involve a synergistic multidisciplinary approach which results in the best outcome in these challenging times.

"The liver is a crucial organ that manages multiple functions in the body, including waste management, metabolism, healing, blood clotting etc. When the liver function is affected by disease, it can lead to severe symptoms such as jaundice, abdominal pain, tremors, swelling in the legs, confusion, mood changes, etc which can affect the child's growth and is very difficult for the child to cope with," said Dr Chetan Ginigeri, Lead Paediatric Intensivist, Aster Hospitals.

The Integrated Liver Care team at Aster has conducted more than 98 paediatric liver transplants and more than 500 adult liver transplants since its inception.

Case 1

Name: Bhuvi Darshka, Bengaluru

Age: 3 years

Donor: Mother

Diagnosis: Hepatic hemangioendothelioma

Case 2

Name: Punyashree, Bengaluru

Age: 5 years

Donor: Mother

Diagnosis: Liver failure

Case 3

Name: Sarvesh, Bengaluru

Age: 6 years

Donor: Mother

Diagnosis: Hepatoblastoma

Case 4

Name: Likitha, Hassan

Age: 7 years

Donor: Father

Diagnosis: Acute chronic liver failure due to WILSON's disease

Case 5

Name: Prerana Pandey, Satna, Madhya Pradesh

Age: 8 years

Donor: Mother

Diagnosis: Acute chronic liver failure (autoimmune liver disease)

Case 6

Name: Kushal, Bengaluru

Age: 10 years

Donor: Father Diagnosis: Chronic liver disease cryptogenic