{"id":1877,"date":"2012-03-30T01:29:43","date_gmt":"2012-03-29T14:29:43","guid":{"rendered":"https:\/\/blogs.rch.org.au\/inthenews\/?p=1877"},"modified":"2015-04-29T13:54:18","modified_gmt":"2015-04-29T03:54:18","slug":"australias-first-paediatric-intestinal-transplant","status":"publish","type":"post","link":"https:\/\/blogs.rch.org.au\/news\/australias-first-paediatric-intestinal-transplant\/","title":{"rendered":"Australia’s first paediatric intestinal transplant"},"content":{"rendered":"
\"\"<\/a>
Mohamed recovering after transplant surgery. View full gallery below.<\/figcaption><\/figure>\n

A 13-year-old boy has made Australian history by becoming the country\u2019s first paediatric intestinal transplant recipient, in surgery performed at The Royal Children\u2019s Hospital (RCH).<\/p>\n

The complex, multi-organ operation \u2013 a collaboration between the RCH and Austin Hospital \u2013 was led by Austin Hospital surgeon Professor Bob Jones last week.<\/p>\n

Mohamed El Shazly had intestinal failure due to gastroenterological condition \u2018Hirschsprung\u2019s disease\u2019. Since infancy his condition has worsened and he\u2019s spent much of his life as an inpatient at the RCH.<\/p>\n

The ten-and-a-half hour surgery gave Mohamed a new liver, small bowel, pancreas and duodenum \u2013 and a second chance at life.<\/p>\n

Professor Jones said the operation went smoothly.<\/p>\n

\u201cPleasingly, the surgery went very much to plan. We removed Mohamed\u2019s original liver and small bowel, but retained his original pancreas and duodenum. We then transplanted the four donor organs (liver, small bowel, pancreas and duodenum) as one package,\u201d Professor Jones said.<\/p>\n

\u201cWhile Mohamed now has two pancreases and two duodenums, only the new organs will function,\u201d he said.<\/p>\n

The team then performed a second procedure days later to completely close the abdominal cavity once swelling had reduced.<\/p>\n

For most of his life, Mohamed has been fed via a tube in his veins. Also known as parenteral nutrition, this method of feeding provides essential nutrients and fluid to sustain life and enable growth and development in patients who are unable to eat.<\/p>\n

RCH Head of Clinical Nutrition, Professor Julie Bines, says intestinal transplantation offers Mohamed the possibility of achieving nutritional dependence.<\/p>\n

\u201cWhilst parenteral nutrition has been keeping Mohamed alive as he waited for a transplant, it is associated with potential life-threatening complications such as sepsis, loss of venous access, metabolic complications and liver disease.<\/p>\n

\u201cNot only does intestinal transplantation reduce these risks for Mohamed, we hope he will soon have the ability to satisfy his desire for food and eat just as an average boy does,\u201d Professor Bines said.<\/p>\n

RCH Head of Liver and Intestinal Transplantation, Associate Professor Winita Hardikar, says Mohamed is recovering steadily after last week\u2019s operation.<\/p>\n

\u201cMohamed is a courageous, resilient boy. He endured the operation well and is recovering as we\u2019d hoped, but he does have a challenging journey ahead,\u201d A\/Professor Hardikar said.<\/p>\n

\u201cThere is still a high risk the body will reject the new organs and infection is also possible. We need to monitor his progress closely and provide months of high level care before we can declare the surgery a success,\u201d she said.<\/p>\n

The RCH has been working in collaboration for some time with Austin Hospital on the development of an intestinal transplantation program.<\/p>\n

A\/Professor Hardikar said the development of intestinal transplantation at the RCH was a logical progression in meeting the clinical needs and expectations of patients with irreversible intestinal failure and their families.<\/p>\n

\u201cThe Royal Children\u2019s Hospital has spent the last 17 years building up our expertise in liver transplantation. We have well-trained medical and surgical staff and the ability to deal with complex illnesses. We also had the benefit of learning from the first adult intestinal transplant performed at the Austin Hospital in 2010,\u201d A\/Professor Hardikar said.<\/p>\n

It was announced soon after the first adult transplant that the next intestinal transplant in Australia would be a paediatric one; however, the RCH waited nearly two years for organs from an appropriate donor to become available.<\/p>\n

\u201cUnlike other organ transplants, an intestinal transplant requires organs of equivalent or smaller size than the recipient. That\u2019s in addition to the usual considerations, such as blood type,\u201d A\/Professor Hardikar said.<\/p>\n

She said Mohamed\u2019s journey has been the culmination of years of hard work from many departments across both the RCH and Austin Hospital.<\/p>\n

\u201cThe teamwork required to keep Mohamed alive has been phenomenal. The medical, surgical, nursing and allied health support has included gastroenterology, clinical nutrition, intensive care, infectious diseases, interventional radiology and anaesthesia, just to name a few,\u201d she said.<\/p>\n

RCH Chief Executive Officer Professor Christine Kilpatrick says the surgery and ongoing complex care of patients with intestinal failure complements the national leadership position of the RCH.<\/p>\n

\u201cThe Royal Children\u2019s Hospital is already a nationally funded centre for paediatric heart, lung and liver transplantation. We hope to develop an intestinal transplantation program, in collaboration with Austin Hospital, which will have a significant impact on the futures of children with intestinal failure,\u201d Professor Kilpatrick said.<\/p>\n

\u201cImportantly, we mustn\u2019t forget that Mohamed has been granted a second chance at life thanks to the generosity of a grieving family. We wish to thank them sincerely, as we do all organ donors, for their selflessness during the most emotional of circumstances,\u201d she said.<\/p>\n

Mohamed was one of a number of patients in Australia in desperate need of an intestinal transplant. To register to become an organ donor, visit www.donatelife.gov.au<\/a>.<\/p>\n

\r\n\r\n