Baby undergoes rare liver transplant

Doctors here have performed a groundbreaking "flipped liver" transplant on a baby, making her probably the youngest person in the world to undergo the controversial procedure.

Rand Sirucek was eight months old in September when surgeons at Mount Elizabeth Novena Hospital took the left part of her father's liver, flipped it, and placed it in the right side of her body.

Such a method has never been used on children here, according to hospitals The Straits Times asked. While the "left lobe in the right" transplant has been recorded in several adults worldwide, it has resulted in rare complications as the liver regenerates.

But Rand, now 10 months old, and her father Cole Sirucek, a 38-year-old American, are doing well, said Dr Jeyaraj Prema Raj.

He is the medical director of the Sing-Kobe Liver Transplant Centre, a collaboration involving doctors from Japan and local medical experts. Dr Tetsuya Kiuchi, another member of the team, said the successful operation may have important implications in the worldwide development of paediatric liver transplants that involve living donors.

The liver comprises two main parts, the bigger right lobe and the left lobe.

A donated liver is usually implanted on the same side it came from to allow for the normal reconstruction of blood vessels and the bile duct.

But Rand's biliary atresia, in which the bile duct between the liver and the small intestine is blocked or absent, had caused several organs on her left side, like the spleen, to enlarge.

That left little room for a transplant there. However, only the left part of her father's liver was suitable for donation. It took a team of 20, including eight doctors, 12 hours to perform the transplant.

They had to be extra careful in reconstructing the vessels and other tissue to make sure the donated liver worked normally, said Dr Prema Raj, who was involved in the operation.

The baby, who was discharged last month, can look forward to a normal life, he said.

Her parents, who have been living here for the past eight years, are thankful that the ordeal which began in March is heading towards a happy ending.

The American couple, who run health-care Web portal DocDoc, said that about three months after their daughter was born, she was diagnosed with liver problems. Without a transplant, the organ would eventually fail.

"At least she won't even remember this part of her life," said Rand's mother Grace Park, 41, who carried her baby into the operating theatre herself.

Her parents will, though.

Mr Sirucek said there are plans to set up a charitable foundation for children with biliary atresia.

"We want to help families who cannot afford this treatment," he said.

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