Since liver transplant was the only permanent solution to save Vayu’s life, his family opted for it. While Vayu's parents were unsuitable for liver donation, his aunt Vidhi Visavadia volunteered to donate a part of her organ. (File)In a rare surgery, a nine-month-old boy has recently undergone an incompatible liver transplant at Mumbai’s Nanavati Hospital where his blood had to be desensitised to remove the antibodies so that his body didn’t reject the transplanted organ.
The infant, Vayu Visavadia, was diagnosed with Biliary Atresia – a rare disorder with complete absence of extra hepatic bile ducts at birth when he was only six days old. Within two weeks, he underwent a corrective surgery to allow for bile drainage. However, the surgery failed so he developed decompensated chronic liver disease with jaundice and other complications.
Since liver transplant was the only permanent solution to save Vayu’s life, his family opted for it. While Vayu’s parents were unsuitable for liver donation, his aunt Vidhi Visavadia volunteered to donate a part of her organ. The team had to plan an ABO incompatible liver transplant as Vidhi’s blood group is A+ve blood group while that of Vayu’s is O+ve.
During the pre-surgical work-up, another major hurdle sprang up for the team when Vayu’s Anti A antibody titers were found to be high and he had developed antibodies against blood group A. “All children develop antibodies after the age of two years but Vayu’s Anti A antibody titers were found to be high at just nine months. This further increased the chance of rejection of the organ,” said Dr Vibhor Borkar, Director, Pediatric Hepatology and Gastroenterology, Nanavati, discussing the rarity of Vayu’s condition.
In preparation for the incompatible liver transplant, Vayu received Rituximab (antibody against CD20 cells responsible for this antibody production) and then a session of plasma exchange to remove the preformed antibody. A day before his planned transplant surgery, CT scan of chest for Vayu showed suspicion of pneumonia (lung infection) again.
However, after several hurdles, Vayu underwent a successful incompatible Living Donor Liver Transplant on August 18. “In medical literature, only five such incidents have been recorded across the globe,” said Dr Anurag Shrimal, Director, Transplant Surgery, at the hospital.