Girl, 8, gets liver cell transplant

By Renee Barnes

December 7, 2004

There is only one thing on the mind of Australia's first liver cell transplant recipient: colouring pencils.

Eight-year-old Rama has Crigler-Najjar syndrome, a rare inherited liver condition, which prevents the organ from removing the yellow pigment from the blood.

The disease, which leads to a yellowing of the skin and brain damage, is treated by intensive light therapy eight hours a day and eventually a liver transplant.

But last week, in an Australian first, doctors at the Royal Children's Hospital in Melbourne took healthy human liver cells, harvested from a donor liver and transfused them into Rama's diseased organ to improve her liver function.

As a result of the operation Rama, whose surname was not given at her parents' request, now faces an end to her light therapy and the start of the life of a normal child.

"I get my colouring pencils," Rama said when asked what was the best thing about going home.

Rama is the first Australian to receive a liver cell transplant, which doctors hope can eventually be used to tackle a number of metabolic liver disorders.

The radical new technique allows healthy cells to be delivered into the liver by a simple catheter and distributed through the organ by its own blood vessels.

It may be used in both children and adults, and is an alternative to the risk of the major surgery involved in a liver transplant.

The Royal Children's Hospital head of hepatology, Winita Hardikar, said Rama has no surgical incisions and was eating and drinking within half an hour of the procedure.

She said it was a simple and safe alternative to a liver transplant.

"With a liver transplant you take the entire liver out and put in a new one," Dr Hardikar said.

"In Rama's case there's only one process that's missing (from the liver), so it's a very gross over-treatment to have a whole liver transplant."

The cell transplant is the result of a five year liver cell bank project at the Murdoch Children's Research Institute.

Katie Allen, who established the liver cell bank, said because donor livers were very scarce the treatment may in future allow many patients to use cells from just one donor.

"When you do an organ transplant you can only use one donor to one recipient or potentially one donor to two recipients if you split the organ," she said.

"... We are taking a whole liver and making it into a bag of cells so we can potentially treat more patients as a result."

Currently a child with a severely diseased liver will die unless a donor organ becomes available.

The liver cell bank hopes to eventually supply hospitals around Australia with healthy cells for transplantation.

Copyright © 2004 The Australian.

This article posted December 18, 2004.