Dr Anurag Shrimal (L) and Dr Lalit Kumar Verma with Shubham and parents Ajay and Shital Gurav
Relentless efforts of city doctors helped save Shubham Gurav from a life-threatening liver condition.Shubham Gurav is chatting merrily with his parents at the Mira Road unit of Wockhardt Hospitals. The 3-year-old has made a rapid recovery after being operated on for a life-threating condition.
“Shubham’s was a very rare case – he had a urea cycle defect and cirrhosis of the liver,” said Dr Anurag Shrimal, consultant, abdominal organ transplantation and hepato-pancreato-biliary surgery. Sufferers of liver disease – when left untreated – do not survive past their fifth year, said Shrimal. “But, with a liver transplant, most continue to thrive and live long, full lives.” How quickly the condition is detected makes all the difference.
“It’s an inborn error of the metabolism, and in 90 paediatric liver transplant cases that I came across while training at the University of Alberta, only two children had this condition, so it’s very rare. We also found that, by the age of one, kids with similar conditions had severe intellectual incapacity, or they had generalised gross delay – in this case, it was very subtle,” said Dr Lalit Kumar Verma, consultant paediatric – gastroenterology and hepatology.
Shubham was lucky because, as his 28-year-old mother Shital said, “We didn’t suspect anything because he was an energetic child. The only reason we went to a doctor was because Shubham could not hold any food down.” When the family met Dr Verma in May 2016, Shubham weighed a mere 7.8 kg.
“On Day One of his clinical assessment, I found he had a firm liver and an increase in abdominal girth or distension (fluid in the belly),” Dr Verma said. A subsequent blood test confirmed the doctor’s worst fears, and thus began a massive project that involved a lot of teamwork between Wockhardt doctors and a lot of legwork for the parents who had to apply to various trusts to get the funds together for a surgery which, it was estimated, would cost them Rs 16-17 lakhs. Funds for the surgery were sanctioned by the CM’s Relief Fund, the PM’s Relief Fund, and Salman Khan’s Being Human Foundation, but it was only when the Sir Ratan Tata Trust came through with the largest chunk of the payment that the family could breathe a sigh of relief.
“We started working on multiple things at the same time. Our paediatric cardiologist ruled out congenital heart defects; Dr Lalit started working with a nutritionist to optimise Shubham’s medical condition and Shubham also had to gain weight, as scientific studies have shown that for patients who weigh 10 kg, the outcome of the transplant is much better than for those under 10 kg,” said Dr Shrimal.
In the meantime, Shubham’s father, Ajay Gurav, a 35-year-old who works as a helper at an electrical works company, was also examined to see if he could donate a portion of his liver to his son.
Shubham was operated on from 7am to 6pm at Pune’s Sahyadri Hospital on December 12, and he is now well on his way to recovery. But, Dr Shrimal said, “The 30-day survival rate for such cases is 85 per cent; the 1-year survival rate is 80 per cent and by the fifth year, the survival rate comes down to 70 per cent.” Dr Verma adds that “the first patient I had transplanted in Canada (she was 10 months old then) is now 20, and she’s a basketball player.”