Five-month old Kolkata toddler becomes the youngest Indian to undergo liver transplant

Ariana Dey, a Kolkata-based infant, has become the youngest Indian with acute liver failure to undergo successful liver transplant procedure, doctors from Max Super Speciality Hospital in New Delhi said on Tuesday.

Hit by acute liver failure, Ariana had been referred to the New Delhi-based hospital by her doctors in Kolkata.

Ariana’s mother and donor Shayantani Dey told National Herald about the challenges the she and her husband Urjit Dey faced. “Ariana was born a healthy baby who had recovered from pathological jaundice soon after birth,” recounted Dey.

However, when she turned five months old, she fell ill and developed jaundice despite medical care. She did not show any signs of improvement. Instead her health further deteriorated, said Dey.

Doctors at the Post Graduate Institute of Medical, Kolkata advised the parents to meet Dr (Prof) Subhash Gupta, Chairman - Liver and Biliary Sciences - Max Super Speciality hospital, Saket for an immediate liver transplant.

When Dr Subhash realised that baby Ariana needed urgent liver transplant as she suffered severe liver failure which was very unusual for a child of her age, she was made to undergo several necessary tests to prep her for the surgery.

“After conducting multiple blood tests and the Prothrombin Time (PT) test, it was revealed that the baby had acute inner bleeding and her blood clotting ratio was very high i.e. four whereas in normal cases, it is around 0.9 to 1,” said Dr Subhash Gupta at a press conference in New Delhi on Tuesday. The presser was also addressed by Max Hospital’s Dr Sharat Varma and the parents of baby Ariana.

Doctors suspected that she had Galactosemia wherein enzymes fail to break glucose content in the Body. However the confirmation result of the Galactosemia take 1 to 1.5 months to come. Further the biopsy of the infant revealed complete loss of function and viability in the liver, said the doctors.

Dr Subhash, along with Dr Sharat Varma, suggested that it is was a very complex procedure and there were only a few centres in the world which had performed this kind of surgery successfully.

“This is probably the only reported case in India of such a young child to have such a severe illness. I have never seen such a case in the 30 years of my practice,” said Dr Subhash.

First, Ariana’s father came forward to donate his liver but after a few tests it was recognised that Urjit’s liver was too big for the surgery, he says.

“Therefore, Shayantani, aged 30, offered to donate her liver to her daughter. It took doctors 18 hours to prepare for the transplant and 10 hours to perform the same. A team of four doctors, four nurses and an anaesthetist, as well as ICU workers and pediatrists performed this surgery,” the doctor recalls.

Dr Subash says that “it was like sculpturing where doctors had to cut out a a segment of the 1,200 gram liver (of mother) and ‘sculpt it’ (with all veins intact) to 182 grams liver to fit into Ariana’s body.”

This disease is quite rare in the world therefore its symptoms according to the doctors can be change in colour of the stool, change in colour of urine and severe jaundice.

Though baby Ariana has recovered after spending 27 days in the hospital, she will continue to be on medication at least for two years, say doctors.

Apart from such an emotional and mental stress, Ariana’s parents had to go through economic problems. The parents came to know that the whole transplant would cost them around Rs 14 lakhs, which grew to over Rs 15 lakh over time.

Urjit (Ariana’s father) is a dietitian at a local hospital in Kolkata. He says that the couple had to ask for financial help from the relatives since they were told that their daughter had only five days’ time.

“Delhi for us was an unknown place. We have no family here and we were also unaware of the illness our child had had. However, the doctors and the staff were very helpful and comforting,” Shayantani said.