Varadharaj saw his three-year-old son slowly slipping into unconsciousness. A sudden fever that began two days earlier left the boy, who was all set to start school in June, with a catastrophic liver failure. However, a team of doctors put in place a complex support therapy that mimicked the functions of his liver, helping him survive the complete liver failure without requiring a transplant.
Listed for transplant
In 24 hours, the life of Radhesh changed. His liver failed and he quickly became deeply comatose. Doctors of Apollo Children’s Hospital, after listing him for a super-urgent cadaveric liver transplant, put him under a complex Intensive Care Unit liver-support therapy to serve as a bridge to support his life until a liver was found.
“The boy was healthy 20 days ago. He developed sudden fever in April. It was no ordinary fever and was almost fatal as his liver failed suddenly. It was a catastrophic fulminant liver failure. It is like a tsunami originating in the liver that affects the entire body. He quickly became deeply comatose with a dangerously swollen brain. His urine output stopped and he slipped into kidney failure. His blood clotting mechanisms failed with a very high risk of haemorrhage,” Suchitra Ranjit, senior consultant, chief of Paediatirc ICU, told reporters on Tuesday.
Fulminant liver failure could prove fatal in many ways including malignant brain swelling, catastrophic bleeding and uncontrollable infections, and each could cause death before the liver recovers, she added.
With liver transplant being the main guarantee for his survival, the liver transplant team listed him for super-urgent cadaveric liver transplant and also screened his parents and relatives for a living donor transplant. But no suitable liver was found for him.
The boy was ventilated and placed on a chemically-induced coma and provided continuous renal replacement therapy — a technologically advanced form of dialysis, and a dose of daily plasma-exchange, a form of blood purification therapy in addition to continuous brain monitoring and circulatory support, doctors said.
“On day six, his liver that was totally necrotic started to show tiny signs of recovery. The liver recovered slowly. The brain swelling decreased and urine output improved. On April 19, nine days after admission, he was removed from the ventilator,” she said. The next day, doctors refused a matching cadaveric liver as the boy recovered, she added. Doctors said the cause of liver failure was unknown as all tests turned negative.
The patient’s story went viral on a crowd-funding site and sufficient money was pooled in for the procedure, a press release said. Among others, Priyavarthini, senior consultant, PICU, M. Saravanan, consultant nephrologist, and Vasanth Kumar, paediatric intensivist, were present.
Article source: https://www.thehindu.com/news/cities/chennai/complex-support-therapy-helps-3-year-old-boy-survive-liver-failure/article27062712.ece