India's first paediatric twin liver transplant gives Filipino twins a new lease of life
According to doctors, the life-threatening condition is believed to have been transmitted from one twin to the other in the womb, resulting in both children developing the same rare disorder
Indraprastha Apollo Hospitals has achieved a significant medical milestone by successfully performing India's first paediatric twin liver transplant on 23-month-old Filipino brothers, Tyler and Kelly, who suffered from a rare congenital disorder called choledochal cyst type IVA. This complex procedure, involving back-to-back surgeries conducted between late May and June 3, was made possible by donations from the twins' mother and maternal uncle, as their father was medically unfit to donate. The surgeries, which were lengthy due to the children's delicate condition, have resulted in both boys showing healthy liver function and recovering well, with the family expected to return to the Philippines soon. This case highlights India's growing expertise in complex transplant surgeries, the affordability of such procedures compared to global standards, and the critical importance of early diagnosis for infant liver conditions.
Indraprastha Apollo Hospitals has achieved a significant medical milestone by successfully performing India's first paediatric twin liver transplant on 23-month-old Filipino brothers, Tyler and Kelly, who suffered from a rare congenital disorder called choledochal cyst type IVA. This complex procedure, involving back-to-back surgeries conducted between late May and June 3, was made possible by donations from the twins' mother and maternal uncle, as their father was medically unfit to donate. The surgeries, which were lengthy due to the children's delicate condition, have resulted in both boys showing healthy liver function and recovering well, with the family expected to return to the Philippines soon. This case highlights India's growing expertise in complex transplant surgeries, the affordability of such procedures compared to global standards, and the critical importance of early diagnosis for infant liver conditions.
Indraprastha Apollo Hospitals has achieved a significant medical milestone by successfully performing India's first paediatric twin liver transplant on 23-month-old Filipino brothers, Tyler and Kelly, who suffered from a rare congenital disorder called choledochal cyst type IVA. This complex procedure, involving back-to-back surgeries conducted between late May and June 3, was made possible by donations from the twins' mother and maternal uncle, as their father was medically unfit to donate. The surgeries, which were lengthy due to the children's delicate condition, have resulted in both boys showing healthy liver function and recovering well, with the family expected to return to the Philippines soon. This case highlights India's growing expertise in complex transplant surgeries, the affordability of such procedures compared to global standards, and the critical importance of early diagnosis for infant liver conditions.
Indraprastha Apollo Hospitals has successfully performed India's first paediatric twin liver transplant, giving 23-month-old Filipino brothers Tyler and Kelly a new lease of life.
The back-to-back surgeries, carried out between late May and June 3, mark a milestone among the hospital's 645 paediatric liver transplants to date.
What is a choledochal cyst?
Tyler and Kelly were born prematurely, weighing 2 kg and 2.4 kg, respectively. Within two weeks of birth, both developed persistent jaundice and pale stools. Doctors diagnosed them with choledochal cyst type IVA, a rare congenital disorder in which enlarged bile ducts obstruct bile flow, leading to progressive liver damage.
According to doctors, the condition is believed to have been transmitted from one twin to the other in the womb, an unusual occurrence that resulted in both children developing the same rare disorder.
If left untreated, the condition progresses to cirrhosis and liver failure. Over the following months, the twins suffered recurrent gastrointestinal bleeding, abdominal fluid accumulation, poor growth, and repeated hospitalisations.
By the time they arrived in India, both children were malnourished, with visibly bloated stomachs and signs of advanced liver deterioration. Transplantation became their only chance of survival.
Challenges involved:
Finding two compatible living donors for siblings requiring transplants within days of each other is exceptionally rare. The twins' mother donated a 20 per cent liver segment to one child and their father was medically unfit to donate. Their maternal uncle also volunteered to donate his 20 per cent liver segment to the second twin, making both transplants possible.
Tyler's surgery lasted more than 15 hours, while Kelly's exceeded 13 hours, both involving complex surgical reconstruction given the children's small size and fragile condition.
Doctors report that both children have shown healthy liver function and are recovering well on follow-up. Transplanted liver tissue typically regenerates rapidly within the first year, and success rates in such procedures are high, allowing most patients to lead normal, healthy lives, although recipients require lifelong immunosuppressive medication to prevent organ rejection. The family is expected to return to the Philippines within a week, a swift discharge for a case that appeared critical just weeks earlier.
Doctors at the briefing also highlighted the affordability of liver transplant procedures in India compared to global standards, aided by health insurance and support from charitable foundations. Such institutional and community support, they noted, continues to make life-saving transplant surgery accessible to families from across the world, as reflected in this case.
“Behind every complex transplant is a family looking for hope. We are humbled that this family travelled from the Philippines and entrusted us with the care of both their children,” said Shivakumar Pattabhiraman, Managing Director, Indraprastha Apollo Hospitals.
Dr Anupam Sibal, one of the experts who led the complex procedures, called it a historic case, noting that Apollo performed India's first liver transplant in 1998 and has since carried out combined liver-kidney transplants, transplants in babies as small as 3.5 kg, and ABO-incompatible transplants. “Kelly and Tyler are such a powerful example of born together, fought together and saved together,” he said.
Doctors stressed that persistent jaundice and pale stools in infants should never be ignored. Early recognition, followed by prompt referral to specialised paediatric liver centres, can be the difference between a manageable diagnosis and life-threatening liver failure.