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Baby given liver graft from mother: Woman and daughter doing well after transplant operation performed for the first time in Britain

Ceila Hall
Tuesday 19 October 1993 00:02 BST
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A WOMAN and her baby are recovering in a London hospital after surgery to transplant part of the mother's liver into her daughter.

It is the first time in Britain that a healthy adult has been allowed to have part of the liver removed to cure her child although the procedure has been carried out abroad.

The baby was born with biliary atresia, a condition affecting about 70 children a year. Bile ducts are malformed or absent trapping bile in the liver. If not treated, liver damage and death will follow. Surgery to repair the bile ducts had not worked and a transplant was the only remedy.

Before the operations at Kings College Hospital could go ahead, three layers of ethical permission or approval were sought - from the hospital's own ethical committee, from the Royal College of Surgeons and from the Department of Health which decided to sanction a series of five transplants.

Veronica Carolan, 41, from Hampshire, and her 14-month- old daughter Audrey were said yesterday to be recovering well from their operations which took 12 hours on Saturday. Their surgeon, Mr Kai-Chah Tan, said both had good liver function.

Mrs Carolan knew there was a 1 per cent chance that something would go wrong, but all being well her liver will grow to compensate for the lost segment, restoring normal function in two or three weeks.

Mr Tan said: 'There is a shortage of paediatric livers for transplant and this procedure has some distinct advantages. Experience elsewhere over the last four years shows that this procedure has very good results.

'Of course I had reservations. The mother was well and healthy and there is always a risk that something can go wrong. This was planned, elective surgery. The baby was not in a critical condition but we did not want to do this as an emergency procedure for the first time when there is considerable pressure on the parents.'

Data from the United States, Japan and Germany shows parent-child donations result in fewer rejection problems, and that the child is out of hospital in about half the time. The operations are 85 to 95 per cent successful compared to 75 to 80 per cent with cadaver livers.

The surgery itself is not new. Mrs Carolan's operation to remove about a third of her liver is similar to that performed to excise a diseased section.

A segment of the mother's liver was then grafted on to Audrey's liver and blood vessels. Mr Tan described the graft as one of the most successful he had seen.

Dr Roger Williams, director of the Kings' Liver Unit, said: 'About 10 per cent of the children who need new livers die on the waiting list.

'This is a very good procedure. The demand for livers is increasing and we felt it was now necessary to consider these operations.'

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