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Hospital in Barcelona avoids liver transplants in four children with innovative operation

The Abernethy deformity affects one out of 30,000 children and causes severe complications

15 June 2017 05:34 PM

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ACN | Barcelona

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Barcelona’s Vall d’Hebron Hospital successfully avoided liver transplants for four children, who suffer from the Abernethy deformity—a congenital malformation that affect one out 30,000 children—by using a brand new technology for the first time in Spain. The children’s only alternative before was to wait for the disease to cause them brain, lung, or tumor complications, and then to opt for a liver transplant with all of its associated difficulties. Instead, the center successfully tested a surgical intervention that “cures the disease without replacing the organ” according to Javier Bueno, the head of the Hepatic Surgery unit in the Pediatric Surgery Department.

The Abernethy deformity is a congenital anatomic abnormality which keeps the blood in the portal vein—which transports the blood to the liver for purification—from getting to the liver. Instead that blood goes to the vena cava, where it is not purified and thus, the toxins get spread around the body. This can produce severe complications. Bueno explained that these can affect the brain, and therefore, it can mean mental delays in the children, lung problems, or hemodynamic changes, which end up provoking tumors that can become malignant.

To date, the children with this malformation were not operated on until the complications were obvious. Interventional radiology was used, which is a technique in which the Vall d’Hebron Hospital is also a pioneer. It consisted of introducing devices in order to close the communication between the two veins, but this process could not be carried out if the connection was too big, as the device could migrate to the heart. The second option was a liver transplant, a risky operation, which, in addition, forced the patients to take medication for the rest of their lives.   

  • “It is possible to cure the disease without having to replace an organ”

    Javier Bueno · Head of the Hepatic Surgery unit in the Pediatric Surgery Department.

That is why the hospital tested a new technique which also consisted in closing the communication between the portal vein and the vena cava in order to redirect the blood to the liver, a process that can be done in two phases, depending on the pressure in the veins. In this way, Bueno claimed that it is possible “to cure the disease without having to replace an organ” in the cases where interventional radiology cannot be used. The patients’ health improves rapidly and the children recover their quality of life and are able to live their lives right away without any limitations in their diet. They can also do sports. This technique was successfully tested on four children between two and four years old in 2015; and thanks to this operation, the children avoided transplants.

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  • Edu playing with his toys (by Laura Busquets)

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