King’s College Hospital has carried out the first live donor combined liver and small bowel transplant in Europe on a four-year-old girl from Vienna.
Emilia Pierzchala was born with an impaired immune system and a genetically abnormal intestine that needed to be removed, leaving her with a very short bowel and she had to be fed through her veins. Due to deterioration of her liver and bowel functions, the hospital caring for Emilia in Austria referred her to King’s, one of a small number of centres in Europe that can manage such complex patients.
After thorough assessment, Emilia went on the waiting list for a liver and small bowel transplant from a size-match deceased donor. However, her health deteriorated while waiting so alternative options were sought, including the possibility of using live donor organs.
Emilia’s mother, 38-year-old Anna Pierzchala, decided to donate part of her bowel and a segment of her liver to her daughter in an operation that took two months to plan and involved careful consultation with a hospital in the USA, which had previously carried out such intricate surgery. Anna said, “When the team at King’s asked me whether I would consider donating part of my liver and bowel I thought: I gave life to Emilia once, I’ll do it twice.”
The 10-hour operation involved removing 150cm of Anna’s small bowel and part of her liver. Emilia then had to have her own small bowel and liver removed, and her mother’s organs transplanted into her body.
Mr Hector Vilca-Melendez, Consultant Transplant Surgeon at King’s, carried out the pioneering procedure. He said, “When Emilia came to King’s she was very unwell and her condition was deteriorating. A combined liver and small bowel transplant was the only option available to her”.
“It was the first time we had been faced with needing to use a live donor to perform a combined liver and intestinal transplant on a patient so sick but we knew it could be done. At King’s we try to push boundaries to help our patients so after a visit to a hospital in Chicago we planned the surgery meticulously. The operation took place on a Saturday with the assistance of other consultant surgeons and I was so proud of the nursing staff that came in to help even when they were not scheduled to work.”
“Emilia’s mother did an incredible thing. By donating part of her organs Emilia can have a greatly improved quality of life. She can now eat and will be able to go school like other children her age. It was a big operation but Emilia would have died without this surgical procedure, the post-transplant care provided by our medical and nursing team, and the selflessness of her mother.”
Anna Pierzchala added, “We both doing excellently since the transplant, I'm feeling physically and mentally great, and Emilia is so different now. She is happy and engaging, and loves to play. She has a new chance at life and she really is a different child.
“It is very difficult for me to express in words how grateful we are to the specialists at King’s. We had everything we needed at the hospital. The doctors and nurses were like our family. The team there kept us strong through the most difficult of times. We want to say the biggest thank you to everybody, including all the hard work carried out by so many people – some we never met – who played a part in Emilia's care.”
It is now a year since Emilia's transplant and she is back in Vienna with her mother, father and older brother.