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A child from Pakistan, born after 17 years of marriage , undergoes lifesaving liver transplant

Lord Ram’s banishment to the woods had ended in 14 years, imprisonment sentences for even the severest of crimes end in 10 to 14 years. What had she done to deserve such a punishment? Samreen’s mother wondered. She had been married for almost 17 years and was yet to beget a child of her own. It is said that motherhood completes a woman and brings out the best in her. Would she ever experience it? She had suffered repeated miscarriages that had completely drained her body and soul. Pregnant again, she prayed fervently for the successful outcome of this pregnancy. But she had been praying for years and years, she had begun to ask herself – was there a God?

The cry of her newborn baby seemed like a call from the heavens above to uphold her faith. She had never been happier! No sound sweeter! Her husband wept like a baby. They had finally become proud parents to a baby girl. They named their new born jewel, Samreen.

Sadly, their joy was short lived. They had not even settled into their newfound roles, not even learnt to change the diapers properly that their visits to the hospitals began. Samreen had jaundice, and then began visits from one doctor to the other. At 5 months of age, she vomited blood and was hospitalized at Islamabad.  She was detected to have progressive familial intrahepatic cholestasis, a condition in which liver cells are less able to secrete a digestive fluid called bile. Build up of bile in the liver cells leads to liver failure.

She would require regular medications, but there was no way to prevent her liver disease from progressing. She had developed portal hypertension and had repeated episodes of bleeding from her gut necessitating blood transfusions and endoscopies. Every bleeding episode was a potential threat to her life.

Her parents were devastated. It seemed like a sword always dangled over their head. Her mother would go paranoid thinking she would bleed again. She was all but 3 years in age, what years of prayers had brought seemed to be slipping out of her hands. Questions plagued her mind, had she asked for something that was not meant for her? Was the joy of motherhood not destined for her? Is that why they were suffering? Could God be so ruthless?  She would go crazy with grief. Was a gift, a gift at all if it was to be snatched away so soon?  

But Samreen was destiny’s child. She was meant to live. Her doctors in Pakistan advised her for a liver transplant. It was the her only hope. Her parents were terrified of such a major high risk surgery. They chose to put their trust in the Divine and came to India for a liver transplant.

The surgery was a success and she recovered wonderfully. She did have postoperative infections that were treated well. She went home after about 5 weeks in hospital. Finally, life for Samreen and her parents had begun.

The Clinical Perspective Post transplant Samreen developed chickenpox. She did receive prophylaxis but still suffered the infection. As all post transplant patients are on medications to suppress their immunity and chickenpox is highly contagious, an outbreak in the postsurgical unit would have been devastating. She was immediately isolated and all precautions taken.
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Verified By Dr Smita Malhotra
Consultant Pediatric Gastroenterologist & Hepatologist, Indraprastha Apollo Hospital
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