In a remarkable medical feat, doctors in Mumbai removed a two-year-old girl’s entire liver for four-and-a-half hours to excise a massive tumour and then successfully replanted the salvaged portion to save her life. While such complex procedures have been performed in adults, the team adopted this approach as a last-resort, life-saving measure for the child.
No Donor, One Last Option
Ideally, a liver transplant would have offered the best chance of survival. However, with no suitable donors available across the country, the medical team at Wadia Hospital determined that this innovative procedure was the child’s only remaining option.
Tumour Size and Location Made Surgery Impossible
Explaining the challenge, Dr. Pradnya Bendre, Head of the Paediatric Surgery Unit at Wadia Hospital, said the child’s parents could not act as donors because they were undernourished.
“It was a huge tumour, and the dissections required were massive,” said Dr. Bendre, who also leads the hospital’s solid organ transplant unit. The child was diagnosed with hepatoblastoma, one of the most common liver cancers in children.
Despite undergoing multiple rounds of chemotherapy over several months, the tumour failed to shrink adequately. Moreover, it was located just below the heart and involved two major blood vessels, a situation typically classified as inoperable, where transplantation is usually the only solution.
An ‘Out-of-the-Box’ Surgical Plan
After exhaustive but unsuccessful attempts to find a donor at the city, state, and national levels, the team opted for an unconventional strategy. The doctors counselled the parents in detail, explained the risks involved, and obtained informed consent.
Subsequently, surgeons completely removed the liver and placed it on a surgical bench. To preserve organ function, they connected it to a hypothermic machine perfusion system, which circulates a specialised fluid to maintain the liver at a controlled temperature during the procedure.
Expert Oversight and Complex Reconstruction
To oversee the surgery, the hospital brought in Dr. Abhishek Mathur, Chief of Liver Transplant at Wadia Hospital, who had previously performed similar procedures in adults in the United States.
“This approach gave us unparalleled exposure and access to remove the tumour and reconstruct the affected blood vessels,” Dr. Mathur explained. “Once we completed the reconstruction, we auto-transplanted the remaining healthy segment of the liver back into the child’s body.”
Family Faces Financial and Emotional Strain
While the surgery marked the end of one crisis, it also ushered in new challenges for the family. Haseena, Aphsa’s mother, said they now face debts running into several lakh rupees, including initial hospital costs of ₹85,000 and additional expenses incurred over months of treatment.
She added that Aphsa will need another round of chemotherapy, while her father, a daily-wage labourer, lost income during the prolonged treatment period.
A Journey That Came Full Circle
Interestingly, the family had moved to Mumbai from Uttar Pradesh a few years earlier for Aphsa’s grandfather’s cancer treatment at Tata Memorial Hospital. Doctors clarified that the family’s history of cancer was purely coincidental.
Autotransplantation: A Possible Answer to Organ Shortages
As reported by TOI, medical experts noted that autotransplantation—using a patient’s own organ—can help bypass severe donor shortages. In the United States, nearly 1,700 of 17,500 patients on the liver transplant waiting list die each year. In India, the gap is even wider, with around 19,000 patients waiting for just 4,000 transplants annually.
In this context, techniques such as ex-vivo resection or bench surgery, as used in this case, could emerge as a critical clinical alternative, helping bridge the widening gap between organ demand and availability.