Filipino babies with liver cancer get successful transplants performed by Indraprastha Apollo Hospitals

November 28, 2017 - 12:01 PM
Doctors, happy parents and lucky patients: (from left) General Manager of Apollo Hospitals, Mr. Raj Raina; Ms. Mary Grace Almajar and Baby Nathan; Medical Director of Apollo Hospitals, Dr. Sibal; Ms. Rebecky Rubio and Baby Kalem; and Ms. Jonalyn Belista and Baby Briseis.

MANILA, PHILIPPINES — One of India’s leading health care facilities, the Indraprastha Apollo Hospitals shine the bright light of hope on the otherwise hopeless condition of babies born with chronic liver failure, which if not addressed by transplantation, can lead to unwanted death.

“Liver transplantation in acute liver failure is more complex than a regular liver transplant,” said Dr. Anupam Sibal, Group Medical Director, Apollo Hospitals Group and Senior Pediatric Gastroenterologist and Hepatologist, Indraprastha Apollo Hospitals, in a forum held at Shangri-La Makati recently. “We are now able to perform transplants in high-risk cases, very small babies, patients with difficult anatomy and patients with multi organ dysfunction.  We have also performed liver transplants in patients who do not have blood compatible donors.  Our kind of expertise gives hope and happiness to patients from all over the world who come to Apollo Hospitals to seek respite from their ailments.”

“We are privileged to offer hope to babies and children from Philippines. The support structure in Philippines for families is remarkable with parents supporting each other. The support from foundations and support groups is truly exemplary. The ‘pay it forward’ culture is so heartwarming and I have not seen this in other countries,” Sibal added.

Some of the first successes of Apollo Hospitals’ liver transplantation program include: the first pediatric liver transplant in India, the first transplant in acute liver failure in India, the first liver-kidney transplant in India and the first Comprehensive Organ Transplant program at Apollo Hospitals, Chennai. Pediatric Liver transplant at Apollo Hospitals, New Delhi has become one the country’s busiest and rapidly-growing health programs.

Liver transplant is expensive

Filipino parents who have sought options for their ailing babies have also found out that the Apollo liver transplant program offers one of the most affordable packages in the world.

Liver transplant is expensive. In Taiwan, the procedure will cost US$100,000. In Manila, the bill can come as much as ₱4.5M to ₱5M.

Medical Director of Apollo Hospitals, Dr. Anupam Sibal

Indraprastha offers the procedure at 1/3 the price of Taiwan or US$33,000 (approx. ₱ 1.65M) . The package includes pre-surgery requirements and a 22-day stay in hospital after the procedure. Should there be a need for the baby to stay longer in the hospital, the family will not be charged extra.

After the 22-day recovery period, another 1 to 2 months rest outside the hospital is required at USD 30 to 40 per day.

Most patients need fundraisers to save up for the procedure. Some get help from overseas foundations to sponsor the treatment.

LITRO (Liver Transplant Organization) is an organization in the Philippines that help patients that need transplant.

Each family that underwent the liver transplant program has a different story on how they coped with challenges and how the Apollo liver transplantation program has brought new hope to their lives.

One year old Jermaine Briseis J. Belista was advised a liver transplant due to advanced liver failure. She had been admitted to the hospital multiple times due to vomiting of blood.

Her mother Jonalyn says the LITRO group shared with the family a number of ideas on how to raise funds. They sold t-shirts, yema spreads, and crinkles and received donations in kind.

Jermaine’s father was found to be a compatible donor and father and baby son both underwent a successful liver transplant at Apollo Hospitals. Jermaine has fully recovered from the transplantation.

“My baby Nathaniel Almajar had displayed yellow discoloration of eyes and skin which has deepened with time, tells his mom Mary Grace. Nathan was diagnosed with chronic liver disease with Caroli disease, which is a rare congenital disorder of the intrahepatic bile ducts.

The Almajars engaged in various ways to raise money given the costs involved in a liver transplant. The family flew to India on 26 June 2017. Nathan underwent liver transplant on 6 July 2017.

“It took 8 to 10 hours to extract the liver from the donor and another 10 to 12 hours to perform the transplant on Baby Nathan. Two months later, we flew back to the Philippines,” Mary Grace added. “Our family and friends are all very happy that Nathaniel is back home. Nathan had successfully undergone a liver transplantation and was discharged after 3 weeks.

“When Kalen was 2 months old, we noticed his yellowing skin and we thought that simply exposing him to sunlight would help his skin go back to normal, but it didn’t,” Rebecky Rubio narrated. “We decided to bring him to the pediatrician and a series of laboratory tests and ultrasound was done.

Upon hearing the distressing news about Kalen’s actual condition, his parents proceeded to search the internet for hospitals that performed liver transplantation and discovered Indraprastha Apollo Hospital.

Last August 2017, they went to India for Kalem’s liver transplant. It took 10 hours for Kalem’s transplant to be done. He stayed in the ICU for almost 11 days, before he was finally moved to a regular room. Today, Kalem is still taking his medication and making his weekly check-ups here in the Philippines

LITRO (Liver Transplant Organization) is an organization in the Philippines that help patients that need transplant. LITRO Spokesperson, Christopher Sumalpong, said they have listed more or less 60 babies and children needing liver transplant today, most of whom are Biliary Atresia cases.

“LITRO Babies Phils., Inc. is a non-profit organization and we don’t have our own funding yet,” Sumalpong said. “Our support group don’t prioritize anyone because all cases are considered urgent but it’s up to the parents how soon they can process all the requirements for liver transplant. We just guide the parents or members what to do, and what needs to be sent to the foundations who can provide assistance.”

PCSO has given assistance for liver transplant costs before but since last year, the Commission on Audit served notice that the PCSO cannot provide assistance to liver transplant if it will be done outside of the Philippines. Costs for liver transplant performed locally starts from 4.5M and PCSO can grant 1.5M to the hospital per patient.

“We have donors who’d rather have their identities kept private but the main people who have consistently helped liver transplant families are former Manila Vice Mayor Isko Moreno, Sen. Nancy Binay, First Hand Foundation from the US and now BILD German Foundation (Ein Herz Für Kinder Foundation),” Sumalpong said.

Dr. Sibal welcomes the possibility of cooperation to set up a facility similar to Apollo’s liver transplantation program.

“The parents of transplant patients, will say there are so many similarities between the Phils. and India,” Sibal said. “We speak the same language. All the moms will tell you when you enter India, and come to the hospital, everybody speaks the same language.

“We would be delighted to have the opportunity to partner with local teams here. We have developed liver transplant programs in six countries and I believe the solutions need to come from us,” Sibal added. “It’s about our cooperation and we will only be too happy to be of assistance but our job is to assist. Because what we have learned, we are just as happy to share.

The Indian doctor is quick to remind that acute liver disease is tricky. “You only have days to spare. Timing is crucial. You have to do liver transplant immediately. The sooner the better.”