Surgeons at the Vatican children’s hospital in Rome have carried out a pioneering operation in which a Lebanese woman’s kidney and part of her liver were transplanted in her 30-month-old son, who suffers from a rare metabolic disorder. Doctors at the Bambin Gesu hospital performed path-breaking laparoscopic surgery on the left side of the woman’s liver and on her kidney. The boy, named Danil, suffers from primary hyperoxaluria, a severe form of a rare metabolic disease called oxalosis, characterised by the formation of calcium oxalate deposits in organs and tissues.
Oxalosis can cause urinary infections and permanent kidney damage, and in the most severe cases, can stunt the patient’s growth and cause brittle bones that are vulnerable to fractures. It affects one in 100,000-333,000 people.
“This operation could be the first of its kind in the world,” the Bambin Gesu said in a statement.
“We are not aware of previous cases in which laparoscopic surgery has been carried out to transplant the same donor’s liver and kidney one after the other.”
The team at the Bambin Gesu that carried out the laparoscopic transplant in Danil of part his mother’s liver was led by Marco Spada, while the transplant of her kidney to the toddler was spearheaded by Luca dello Strologo.
Laparoscopic surgery to transplant a kidney from a living donor to a recipient is well-established, while the use of the minimally invasive technique for liver transplants is a more recent operation that is only done in the most specialist centres and, in Italy, currently only at the Bambin Gesu.
All such patients treated at the Bambin Gesu have had dialysis during surgery and several days afterwards, and all the operations have been successful, according to the hospital. In the past 24 months, it has performed 32 liver or kidney transplants from living donors and 98 from deceased donors.
The advantages of laparoscopy include a significant reduction in surgical trauma which reduces the length of time patients need to spend in hospital, less need for painkilling drugs, a lower risk of postoperative complications and a more rapid return to normal life, according to the experts.
And thanks to high-resolution (3K and 4K) and three-dimensional imaging technology, surgeons performing a laparoscopy have an extremely detailed picture of the patient’s anatomy, allowing more precise incisions with a lower risk of bleeding.