Narayana Health SRCC Children’s Hospital, Mumbai, has successfully performed a rare living donor liver transplant on a 13-month-old baby boy diagnosed with Alagille Syndrome, a life-threatening genetic liver disorder. This milestone case marks one of the few successful liver transplants in an ultra-low-weight infant.
The child was admitted three months ago with severe jaundice and abnormal liver function. Diagnosed with Alagille Syndrome at just six months old, his condition continued to deteriorate which led to chronic liver disease and failure to thrive. Given the progression of the disease and the child’s poor prognosis, a living donor liver transplant was planned with his mother volunteering as the donor.
The surgery, which lasted 12 hours, was particularly challenging due to the child’s ultra-low body weight of just 5.5 kg (5 kg dry weight) and his small body surface area. The team faced significant hurdles, including the removal of the cirrhotic native liver and the implantation of a relatively large donor graft.
Dr Ashok Thorat, senior consultant— liver transplant and HPB surgery said, “One of the most complex aspects of the surgery was the size mismatch between the donor liver graft and the child’s small abdominal cavity.”
He further explained, “We had to reduce the graft size meticulously, preserve the vascular structures, and perform delicate vascular anastomosis using high-magnification lenses for precision. Minimizing blood loss and maintaining graft integrity were critical to success.”
Postoperatively, the child was cared for in a dedicated pediatric liver transplant ICU under stringent aseptic conditions. He was mechanically ventilated for the first three days and extubated on the fourth postoperative day. After two more days of close monitoring in the ICU, the child was shifted to a private room for further recovery. Thanks to the multidisciplinary approach of the clinical team, the child’s recovery has been smooth.
“Performing a living donor liver transplant in an ultra-low-weight infant is an extremely high-risk and technically demanding procedure,” added Dr. Thorat. “Only a handful of surgical teams globally have the expertise to manage such cases successfully,” said Dr Zubin Pereira, facility director at Narayana Health SRCC Children’s Hospital, who praised the team’s efforts, “This successful outcome is a testament to the skill, dedication, and teamwork of our specialized transplant unit. We remain committed to offering advanced, life-saving care to even the most vulnerable pediatric patients.”
