3-Year-Old Undergoes Liver Transplant After Treatment for Rare Liver Disease in Chennai
Chennai: Doctors at Rainbow Children’s Hospital, Chennai, have successfully performed a living-donor liver transplant on a three-year-old child diagnosed with Langerhans Cell Histiocytosis (LCH) and severe liver dysfunction, after also treating a congenital urinary abnormality that caused recurrent infections.
The child was initially brought to the hospital with jaundice. Investigations confirmed LCH with significant liver involvement, with bilirubin levels rising to around 10–12 mg/dL. Chemotherapy was started, but the treatment had to be carefully modified because of the child’s severe liver dysfunction. Newer targeted therapy subsequently produced a significant response.
During chemotherapy, the child developed recurrent urinary tract infections. Further evaluation by the pediatric nephrology and urology teams identified congenital vesicoureteric reflux (VUR), a condition in which urine flows backwards towards the kidneys.
As the infections posed an additional risk before transplantation, the urinary abnormality was corrected through ureteric reimplantation surgery, followed by placement of a temporary stent. The child was subsequently stabilised for liver transplantation.
A multidisciplinary team involving pediatric hepatology, liver transplantation, pediatric surgery, nephrology, urology, hemato-oncology, intensive care and anesthesiology was involved in the treatment.
The child underwent a living-donor liver transplant, receiving the left lateral segment of his father’s liver. The surgery lasted approximately 10 hours and was followed by eight weeks of close monitoring.
The child later received four additional rounds of chemotherapy for LCH. According to the hospital, follow-up evaluations showed no evidence of LCH, while the recurrent urinary infections had also resolved.
The transplant was performed by Dr. Mettu Srinivas Reddy, Group Director, Department of Liver Transplantation & HPB Surgery, and Dr. Somashekara H R, Senior Consultant, Pediatric Hepatology & Liver Transplantation, along with the multidisciplinary team at Rainbow Children’s Hospital.
Doctors involved in the case said that addressing the urinary abnormality before transplantation was an important part of reducing infection risk and preparing the child for the transplant.
