Mumbai, Jan 20: In a landmark medical achievement, doctors at Bai Jerbai Wadia Hospital for Children, Mumbai, have successfully performed a rare and highly complex liver auto-transplantation on a two-year-old child with advanced liver cancer.
The breakthrough is being hailed as the first such procedure in India in both adults and children and, according to the medical team, may be the first reported case of its kind in a child anywhere in the world.
Diagnosis and treatment challenges
The patient, two-year-old Aphsa, was diagnosed in June 2025 with advanced hepatoblastoma after her mother noticed swelling in her abdomen.
Hepatoblastoma is among the most common liver cancers in children, but Aphsa’s tumour was centrally located and involved major blood vessels, making conventional surgery impossible.
Although chemotherapy led to partial tumour shrinkage, it remained inoperable. A liver transplant—normally the treatment of choice—could not be performed due to the absence of a suitable living or deceased donor during the critical post-chemotherapy window.
Extraordinary surgical approach
Confronted with these challenges, a multidisciplinary team led by Dr Abhishek Mathur opted for an extraordinary life-saving approach: paediatric liver auto-transplantation using an ex-situ technique. On December 12, 2025, during a 14-hour surgery, Aphsa’s entire liver—weighing just 500 grams—was removed from her body.
Nearly 70 per cent of the cancer-affected liver was excised outside the body, while the remaining healthy 30 per cent was carefully preserved, reconstructed and re-implanted.
Use of advanced perfusion technology
To minimise the risk of liver injury while the organ was outside the body, the team used advanced oxygenated hypothermic machine perfusion, a novel technology that continuously cools and perfuses the liver. This approach is rarely reported even in adult liver cancer cases and has never before been described in children under similar circumstances.
Team coordination and planning
The surgery required exceptional coordination. While one team removed the tumour and reconstructed the liver on the perfusion machine, another simultaneously rebuilt major blood vessels inside the child’s body. Specialists from paediatric surgery, liver transplantation, anaesthesiology, intensive care, radiology, pathology and oncology worked in close synchrony.
Dr Mathur said the surgery required meticulous planning. He documented every step in advance, reviewed it repeatedly with the team, and mentally rehearsed the entire procedure even before entering the operation theatre.
Support and accessibility
Dr Pradnya Bendre, Head of Solid Organ Transplant and Head of Paediatric Surgery, said the procedure was made possible by access to the perfusion machine, which was provided free of cost by Duraent Lifesciences.
“The machine normally costs up to Rs 3 lakh per day to rent, and its availability was crucial in ensuring this advanced treatment was accessible to Aphsa’s underprivileged family,” she said.
Recovery and impact
Aphsa made an excellent recovery, was shifted out of the ICU within a week, and discharged soon after. While she will require further chemotherapy and close monitoring, her survival stands as a testament to medical innovation and teamwork.
“This surgery transformed an impossible situation into hope,” said Dr Minnie Bodhanwala, CEO of the hospital. “Auto-transplantation can redefine outcomes for children with otherwise untreatable conditions.”
“When we were told how serious her condition was, we were shattered,” said her father, Saddam Hussain Shaikh. “This procedure became our only hope. Seeing our daughter smile again feels nothing short of a miracle.”
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Cost and social support
With support from social organisations and government schemes, the hospital performed the surgery free of cost for the family. In a private hospital, however, the procedure would typically cost between Rs 15 lakh and Rs 20 lakh.
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