April 2008

Mum gives son gift of life in Victoria-first transplant

Surgeons from the Austin Hospital have performed Victoria’s first living-related liver transplant after a young mother donated a segment of her liver to her year-old son.

While living-related liver transplant has been performed at hospitals around the globe for some 18 years, Victorian surgeons have resisted this form of transplant as it puts an otherwise healthy person through a complicated surgery that carries the risk of serious complications, even death.

Director of the Victorian Liver Transplant Unit at Austin Health Bob Jones said he and his team were reluctant to conduct living-related transplants and transplanting organs from deceased donors would remain the preferred option.

‘Currently, between 10 to 15 per cent of patients waiting for a liver transplant die before a suitable organ is offered to them and it is for this reason we have embarked on living-related transplants,’ Professor Jones said.

‘In many respects, we are behind the eight ball as many hospitals have been conducting this type of surgery for years but putting an otherwise healthy person through a dangerous operation is not a decision any surgeon wants to make lightly.

‘In Dylan’s case he faced a long wait for a transplant and if we were going to go through with using his mother as a donor we had to do it sooner rather than later while he was still in relatively good condition and give him the best chance of survival.’

Dylan Nish had been in the care of specialist gastroenterologists at the Royal Childen’s Hospital since being diagnosed with biliary atresia when he was eight weeks old.

The disease does not allow bile to be drained from the liver, causing it to build up and result in cirrhosis.

‘When admitted to the hospital, Dylan was malnourished because his body was not able to absorb fats and other nutrients,’ said Head of Hepatology at the RCH Winita Hardikar.

‘His belly was severely swollen with fluid and he was at risk of life-threatening bleeding due to his liver disease,’ Professor Hardikar said.

‘He needed intensive treatment to get him to a size where he had a reasonable chance of survival after a liver transplant.’

Upon discovering a successful liver transplant was the only way for Dylan to survive, his parents Jennifer and Daryl investigated the option of living-related  transplant knowing his chances of receiving a liver from a deceased donor were limited given Australia’s current rate of organ donation.

‘We jumped at the offer of living-related transplant due to the lack of available donors in Australia,’ Mrs Nish said.

Daryl Nish will never forget the day he waited for his wife to recover from an eight-hour surgery at the Austin Hospital and his baby to come through a 12-plus-hour operation.

‘It was a very, very long day,’ Mr Nish said.

‘It was also very emotional, especially when you have to watch your wife and son both undergo surgery on the same day but on the other hand it was an exciting day because we had a potential new start to life as a family.’

After donating the left lateral segment (about 25 per cent) of her liver to Dylan, Mrs Nish made a quick recovery.

Her liver will regenerate to its original size and her donated segment of liver will grow with Dylan in the years to come.

•           To register as an organ donor, telephone 1800 777 203 or visit www.medicare.gov.au.