By Sachin Murdeshwar

Mumbai: A specialized Paediatric Liver Transplant team led by Dr. Ravi Mohanka and Dr. Anurag Shrimal at Global Hospital, Parel, Mumbai, successfully performed a complex liver transplant surgery on 8.5-month-old baby girl. She weighed only 4.7 kgs at the time of her surgery making her the lightest baby in western India to have a successful liver transplantation.

Baby Ipsa Krunal Valvi, of Surat, developed jaundice immediately after birth. Further investigations revealed that she suffered from a rare liver disease known as Biliary Atresia (BA), where there are no bile ducts in the liver from birth. Bile becomes stagnant in the liver and causes permanent liver damage and cirrhosis. The family was in a rude shock as her health was continuously deteriorating. In such a condition, there is a surgical option available if the condition is diagnosed within 90 days. Since the diagnosis was done after 3 months of birth, the only option left was to do a liver transplant.

Dr. Anurag Shrimal, Paediatric Liver Transplant Surgeon at Global Hospital, Parel, Mumbai, highlighted, “Baby Ipsa was suffering from Biliary Atresia, which is very rare and found only 1 in 20000 kids. But, in this case, she was diagnosed with it beyond the age of 90 days. So, it was difficult to perform a Kasai portoenterostomy procedure for BA which is an alternative for liver transplantation. Hence, the only treatment option left to save the baby was a timely liver transplant.”

Dr. Vibhor Borkar, Paediatric Hepatologist at Global Hospital, Parel, Mumbai, said, “As Ipsa was becoming older her liver disease was getting worse. She developed Jaundice, ascites (fluid in her belly) and most importantly stopped growing. Despite the best efforts her condition worsened, she started developing infections requiring multiple hospital admissions.”

Dr. Shrimal added, “Baby Ipsa’s liver transplant surgery was performed successfully in June 2019. Liver transplant surgery in babies less than 5 kg is one of the most challenging operations. In small babies the blood vessels are very small and joining them to transplanted liver requires a special skill set. The complex surgery was almost blood-less and she required only 30 ml of blood during the entire surgery. The post-operative recovery of tiny infants is as challenging as the surgery. Strict asepsis and attention to every detail is an absolute must.”

She recovered well from the surgery, and was discharged within three weeks. After surgery, her jaundice gradually disappeared, she became more playfull, alert, and could catch up developmental milestones for her age.

Speaking on the occasion Dr. Vivek Talaulikar, CEO-Global Hospital, Mumbai said, the liver transplant team has come a long way, building the comprehensive and specialized trained team of doctors, surgeon, nurses, anesthetists, intensivists and related support staffs. The team has been incessantly working towards providing the best care to the patients starting from the evaluation of the disease until the post-operative rehabilitation. A commendable effort has been put by the liver transplant team to perform this challenging surgery along with managing the baby during post-operative period to keep infections at bay.  Thus, we have been able to set up the most successful liver transplantation program in western India and the only program doing dedicated Paediatric Liver Transplantation Service on a continual basis.

Mrs. Suchitra Valvi, Mother of baby Ipsa, I was happy when I got to know that I delivered a beautiful baby girl. But my happiness was short-lived as she suffered from jaundice and required medical attention on an urgent basis. To our dismay, she was also diagnosed with rare life-threatening liver disease and needed a liver transplant. As parents, we were deeply saddened to see our baby in that excruciating pain. But Global Hospital gave us hope and helped Ipsa cheat death. We thank the doctors and especially Ms. Krupali, Ipsa’s masi who came forward to give her a new way of life.