A rare and complex liver transplant was carried out by a team of proficient doctors at Artemis Hospitals, Gurugram. They performed a 14-hour long rare surgery called Monosegment (Segment 3) liver graft transplant on a one-year-old girl child from Saudi Arabia. Baby Fatima (name changed) underwent an extremely rare living donor Liver transplant (Monosegment), where only 1 out of 8 portions of liver was used to provide a new liver to the baby.
The surgery called Monosegment (Segment 3) living donor liver transplant is the first reported case of Delhi NCR in which monosegmented liver graft has been used. Beside this use of bovine jugular vein in liver transplant has been reported for the first time in the world, to provide an inflow of blood to the newly transplanted liver as baby was born with absence of bile ducts and under developed portal vein.

Managing the child during such a long surgery was a tedious and tricky task; it was meticulously and successfully handled by a team of specialist doctors and paramedics.

Born as a third child to parents Ahmed and Sarah, the child had unusually prolonged and deep jaundice months after her birth. Doctors in Saudi Arabia diagnosed her with a rare disease called biliary atresia which is found in 1:16000 live births. The developments of bile ducts in such children are absent. Fatima underwent biliary bypass surgery at a local hospital in Saudi Arabia before coming to India.

Due to the unsuccessful and unsatisfactory outcome of biliary bypass surgery, she was advised Liver Transplantation by the doctors in Saudi Arabia. However, considering her poor nutritional status and body weight (5.2kg) doctors in Saudi Arabia were reluctant and unwilling to perform such a complex liver transplant and she was referred to India.

Dr. Giriraj Bora, Joint Chief – Liver Transplant & Sr. Consultant – GI & HPB Surgery at Artemis Hospitals said – “Transplant in babies weighing less than 6 kg is considered to be extremely complex and even a left lateral lobe from the donor (mother in her case) was big for such a small baby. Other major challenges were to get a blood supply for the new Liver as Portal Vein (main blood vessel to supply blood to the liver) was absent in the baby and we had to find a way to overcome this complex problem.”

Dr. Ramdip Rey, Joint Chief – Liver Transplant & Sr. Consultant – GI & HPB Surgery at Artemis Hospitals said – “Her mother was the only available donor but big grafts can cause a blood vessel to thrombose (clotting of blood) soon after transplant and the entire graft is lost in many cases.”

He further said, “As per the Liver Transplant Team and to the best of our knowledge, this is possibly the first of its kind surgery performed in Delhi NCR.”

Her mother Sarah, Liver donor is perfectly fine and healthy. She is happy seeing her baby doing well after surgery.

She said, “We have no words to describe the wonderful experience and care we got at Artemis Hospital. We had lost all hope after our baby was denied surgery at Saudi and during those difficult times we came to know about quality and cost-effective Liver Transplantation being done in India.”


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