At St Nicholas Children’s Hospital of the First Medical Association of Lviv, a liver transplant has been performed for the first time on a 7-month-old child. The patient was Davyid Matrofailo from Ivano-Frankivsk region. The operation lasted around 12 hours and became the most complex paediatric transplantation in the history of this institution.
The boy’s health problems appeared at three months of age, when his parents noticed jaundice and took him to a paediatrician. After examinations in local and regional hospitals, the family was referred to Lviv, where specialists at St Nicholas Hospital diagnosed biliary atresia. This is a congenital progressive disease in which the outflow of bile from the liver to the intestine is blocked. Doctors stressed that without a liver transplant, children with this diagnosis usually do not live to one and a half years.
Davyid’s father, Roman, agreed to become his donor, and his test results fully met the requirements. At the same time, the doctors could not operate immediately — the child was too small for transplantation, so before starting preparation the boy needed to gain weight to around 10 kg. Because of his serious condition, this proved extremely difficult: the child was given tube feeding and every effort was made to provide his body with as many nutrients as possible, but complications of cirrhosis developed — ascites, a high level of bilirubin and portal hypertension.
Despite more than three months of intensive efforts, before the operation Davyid weighed about 9.5 kg, with his ‘actual’ weight only 6.2 kg, and the rest due to oedema and ascites. An additional challenge was the very small diameter of the hepatic artery — about 2 mm. However, it was no longer possible to postpone the transplant.
To carry out the living-donor transplant, specialists from three medical institutions joined forces: St Nicholas Hospital, the Transplantology Centre of the First Medical Association of Lviv, and the O. O. Shalimov National Institute of Surgery and Transplantology in Kyiv. A team of surgeons, anaesthetists and theatre nurses worked in the operating theatre for about 12 hours.
During the procedure, part of the father’s liver was transplanted to the child. The donor fragment began functioning while still on the operating table and successfully took in the infant’s body. The parents stressed that they placed their full trust in the doctors and were convinced that their child had to be given a chance at life.
Davyid is now eight months old. Doctors note positive progress: the yellow tinge of his skin and sclera is fading, the boy has become more active, he is feeding well and smiles at his doctors during routine check-ups.
The Transplantology Centre of the First Medical Association of Lviv recalls that the institution has led the national statistics on the number of transplants for five years in a row. Around one in ten operations is performed on children, who have the highest priority on the waiting list due to their emergency status.
It was in Lviv that Ukraine’s first combined “pancreas–kidney” transplant was carried out, as well as the first “heart–lung” transplant and a successful split-liver transplantation.