Suresh Krishnarao*
Citation: Suresh K. Biliary Atresia-Challenges of Liver Transplantation. Medp Public Health Epidemiol. 2022; 1(1): mpphe-202210002.
Abstract
Objective: Biliary Atresia is a rare condition in early infancy in India, as nearly 2500-5000
such children are born each year. Liver transplantation is a highly successful treatment for
biliary atresia, as survival after surgery has increased dramatically in recent years. However,
the poor awareness about needs and urgency for liver transplantation for young infants born
with Biliary Atresia, availability of donors and lack of facilities for transplantation surgeries,
and socioeconomic inequities in accessing the service across the world including advanced
countries like USA and UK lead to children experiencing long waiting times for procedure. The
objective of this publication of clinical cases is to describe epidemiological risk factor; ordeals of
liver transplantation in India and raising an alert for better preparedness of the health system
and other stakeholders.
Location: Case reports of two liver transplants in Mumbai and Bengaluru in August 2022.
Participants: In this review 2 liver transplant surgeries one each in Mumbai and Bengaluru,
India in August 2022 are discussed to drive the need for a comprehensive effort from the
Government, families and the health insurance companies. The first case was of an infant
of 9 months old boy, who underwent within two weeks of birth a corrective surgery (Kasai
procedure) to allow for bile drainage, but the surgery failed and resulted in decompensated
chronic liver disease with jaundice and other complications needing liver transplantation. He
had to undergo an incompatible liver transplant with an aunt’s donated liver as parents were
unsuitable. The second case was of a 11-month-old boy needing primary liver transplant due
delayed manifestation (at 6 months), diagnosis and mobilizing resources.
Measurements: The operating procedures and the outcome in the first month. The financing
mechanism for the procedure and limitation of country’s health assurance scheme.
Results: The immediate outcome of both the liver transplants were encouraging.
Conclusion: liver transplantation for Infants with Biliary Atresia is an urgency, but as of
now must wait for long. families, government, insurance companies and even the facilities and
surgeons need to join hands for this arduous process. Unless exceptional attention is granted it
is difficult to save the children.
Materials & Methods: Reports on the ordeals of two cases of Liver transplants one in
Bengaluru and another in Mumbai, India in August 2022.
Key Words: Bile Duct; Biliary Atresia; Liver Transplantation; Porto-Enterostomy; Ayushman
Bharat; State Health Assurance Schemes.
No comments:
Post a Comment