On 7 March, a Living Donor Liver Transplantation was successfully performed, with the boy's mother donating a portion of her liver.
Published Apr 19, 2025 | 9:31 AM ⚊ Updated Apr 19, 2025 | 9:31 AM
The teen had been living with the effects of Marfan Syndrome, a genetic disorder. (Supplied)
Synopsis: Osmania General Hospital in Hyderabad performed a groundbreaking liver transplant on 14-year-old boy, battling both Marfan Syndrome and severe Hepato-Pulmonary Syndrome. Despite high surgical risks, a multidisciplinary team successfully completed the procedure, with his mother donating a portion of her liver. Funded by the Chief Minister’s Relief Fund, the surgery marks a global first and a major medical milestone.
Doctors at Osmania General Hospital (OGH), a government-run institution in Hyderabad, performed a rare and complex liver transplant on a 14-year-old boy battling not just one, but two life-threatening conditions — Marfan Syndrome and Hepato-Pulmonary Syndrome (HPS).
The patient, hailing from Gokavaram in Andhra Pradesh’s Krishna district, had been living with the effects of Marfan Syndrome, a genetic disorder that affects the body’s connective tissue, since early childhood. But in recent years, the disease had taken a harsher turn — his liver began to fail, and his lungs, too, struggled to provide his body with the oxygen it needed.
At the time of admission, the patient was a shadow of a typical teenager — rail thin, struggling to breathe, and surviving on dangerously low oxygen levels. The simplest acts of daily life had become a struggle. “His room-air oxygen saturation was just 68 percent,” said Osmania General Hospital in a statement. “He was barely able to walk a few steps without breathlessness.”
The boy’s medical journey had been long and arduous. At just 18 months, he lost vision in his left eye due to complications from congenital glaucoma. By age 7, cyanosis — a bluish tint to his skin and nails due to poor oxygen — had started showing up. It was during this evaluation that doctors suspected a genetic abnormality. Later, at age 12, he was diagnosed with jaundice during a routine check for a tonsillectomy, and further testing at CMC Vellore confirmed chronic liver disease with associated HPS.
The patient’s family, daily wage labourers, had already faced an uphill battle due to their limited financial means. Yet, against all odds, hope arrived in the form of Osmania General Hospital.
By the time he reached Osmania General Hospital, his condition had become critical. The team at OGH — despite the immense challenge posed by his dual diagnosis — took up his case. A battery of tests confirmed the worst: The boy was suffering from severe hepatopulmonary syndrome, a rare and often fatal complication, especially in children with underlying genetic disorders like Marfan Syndrome.
Marfan’s syndrome is a rare genetic disorder affecting connective tissue, caused by mutations in the FBN1 gene. It impacts the heart, eyes, and skeleton, often presenting with long limbs, joint hypermobility, and serious cardiovascular complications such as aortic aneurysms. Its multisystem involvement makes surgical interventions especially risky due to fragile tissues.
Hepato-pulmonary syndrome (HPS), on the other hand, is a severe complication of chronic liver disease marked by liver dysfunction, low oxygen levels (hypoxemia), and abnormal dilation of pulmonary vessels. This impairs oxygen exchange in the lungs, causing extreme breathlessness and severely reducing quality of life.
While liver transplantation is the only curative option for HPS, it becomes far more complex when combined with Marfan’s syndrome due to increased surgical risks. Managing both conditions simultaneously requires an extraordinary level of medical expertise.
According to the statement from the hospital, in a historic global first, doctors at Osmania General Hospital, Hyderabad, performed a successful liver transplant on a young man with both very severe HPS and Marfan’s syndrome. This medical milestone showcases how multidisciplinary collaboration and public healthcare commitment can overcome even the most formidable challenges in modern medicine.
After careful deliberation by a multidisciplinary team comprising experts from cardiology, pulmonology, anesthesiology, radiology, gastroenterology, and surgical gastroenterology, it was decided that liver transplantation offered the best—and only—chance of survival for the young boy.
Preparing for this major surgery was no ordinary task. Marfan’s syndrome, a connective tissue disorder, made the patient’s tissues especially fragile and significantly increased the risk of cardiovascular complications during the procedure. On 7 March, a Living Donor Liver Transplantation was successfully performed, with the boy’s mother donating a part of her liver.
“The surgical team encountered expected challenges due to the patient’s underlying Marfan’s syndrome, including tissue fragility and cardiovascular risks,” the hospital stated. “However, the procedure was completed without significant complications, and the patient was transferred to the intensive care unit for postoperative care.”
The surgery was led by a team that included Prof Dr CH Madhusudhan Head of Department, Surgical Gastro Enterology.
Post-surgery, the boy was managed in the ICU for over a month using non-invasive ventilation. “Today, his room air oxygen saturation stands at 90 percent, and the transplanted liver is functioning well,” said the doctors. “To the best of our knowledge, this is the first case in the world where liver transplantation has been successfully performed for very severe HPS in a patient with Marfan’s syndrome.”
The hospital also added that the successful treatment of very severe hepatopulmonary syndrome in a patient with Marfan’s syndrome through liver transplantation marks a significant milestone in medical history.
The hospital said that the procedure, performed under the Chief Minister’s Relief Fund (CMRF) at a cost of ₹10 lakh, would have cost over ₹60 lakh in a private hospital—an amount far beyond the reach of the patient’s family.
(Edited by Sumavarsha).
