Two sisters – and the first liver transplant from a recovered COVID19 patient

How a transplant team in Delhi operated during lockdown on a girl, the donor was the sister who had just beaten COVID19

A thrilling medical crisis worthy of an episode in  ‘Grey’s Anatomy’ played out in a prominent liver transplant unit in the capital while Covid19, lockdown and the associated scare spread like wildfire across the country.

Lisa (name changed), a 12 yr girl from a remote village in West Bengal was suffering from Caroli’s disease – a rare condition where a person’s liver is replaced with sacs of bile. To add to her woes, those sacs got repeatedly infected and she had recurrent episodes if fever, yellow eyes (jaundice). Things came to such a pass that antibiotics were of no use as the bacteria developed resistance.

Her only hope was a liver transplant.

In the middle of lockdown, the team decided to go ahead with a liver transplant.
This was  the first liver transplant performed on a donor who had recovered from covid.

Lisa was admitted in one of the premier liver transplant units of the country in the middle of March 2020, just before India went into a lockdown. Living donor liver transplant is the main way a liver transplant is performed in India, where a person donates a part of his liver to the patient with a diseased liver. Unfortunately, both of Lisa’s parents were unsuitable for donation. Her elder sister Misa, a biology honours student and only 19 yrs of age was the only eligible donor in the family.

By the time she was ready to donate, the lockdown was enforced, and the family was left with little social and financial support. Adding to the family’s woes, Misa was found to be Covid positive on testing and though she did not have any symptoms, she was sent to a quarantine center following prevalent guidelines. Her father was kept in isolation and Lisa and her mother stayed in the hospital.

To make things worse, Lisa deteriorated clinically and needed constant ICU care.
Only aftet repeated testing did Misa turn out to be covid negative and was released from the quarantine center after 3 weeks.

The family had meanwhile used up all resources and depended on crowdfunding for treatment. In the middle of lockdown, the team decided to go ahead with a liver transplant.
This was  the first liver transplant performed on a donor who had recovered from covid.

Both the donor and the recipient made a gradual recovery and were finally discharged.
One fallout of the covid pandemic has been the relative lack of attention to other medical illnesses. Indeed, illnesses like cancers, liver disease progress relentlessly, but care has suffered because of the raging pandemic.

Lisa’s case is a proof of that phenomenon.

Covid and the associated lockdown did create impediment in her treatment pathway, however she did manage to make it through.