The idea of undergoing the procedure was ‘mentally and emotionally draining’, the longtime Abu Dhabi resident said, but doctors eased her worries
Fatima Ali (centre) with her medical team.— Photo: Supplied
Published: Fri 26 Apr 2024, 11:21 AM
Last updated: Fri 26 Apr 2024, 10:44 PM
Fatima Ali, who was struggling with life-threatening conditions like advanced liver cirrhosis and cancer, needed a transplant to survive.
Placed on a waitlist, the Abu Dhabi resident got phone calls thrice for a transplant, but the donor’s liver didn’t match on each occasion because of several medical reasons. And when the 66-year-old Yemeni expat had almost given up hope, her phone rang again.
In March, the Burjeel Transplant Office at Burjeel Medical City (BMC), Abu Dhabi, informed her about a 23-year-old Indian man who suffered a traumatic brain injury and sustained severe brain stem dysfunction. He was declared brain dead. The National Centre for Regulating Donation and Transplantation of Human Organs and Tissues approached the family of the deceased expat. And with a heavy heart, the family consented to organ donation.
“I was overwhelmed when I got the call,” said Fatima, who thanked the selfless decision of the donor’s family.
After battling liver cirrhosis and liver cancer for two years, she returned to normal life following a liver transplantation at BMC — the flagship facility of Burjeel Holdings.
Fatima is the first patient to undergo liver transplantation at BMC. The hospital already has a successful kidney transplant programme.
Fatima, an educational adviser, is a long-time resident. A mother of three, she has been a role model to her children, who are all specialist physicians in Abu Dhabi.
Her life took a downturn when she was diagnosed with autoimmune hepatitis, a condition where the body’s immune system attacks liver cells. In 2022, she was diagnosed with decompensated liver cirrhosis. A year later, she developed liver cancer. She consulted doctors at BMC who, considering the severity of her condition, recommended a liver transplant.
Since last year, Fatima has been under the care of Dr Rehan Saif, director of the Burjeel Abdominal Multi-Organ Transplant Programme at BMC.
“The idea of undergoing a liver transplantation was mentally and emotionally draining,” said Fatima, who was worried about different aspects of the surgery such as the risks involved, consequences, success rate, recovery time, life expectancy, and the quality of life afterward.
“Gathering information online and from other unofficial sources scared me. When I met Dr Rehan, he put me at ease by explaining the need for a transplant to cure my liver cancer and the underlying liver cirrhosis. He erased my fear by explaining the process and how it’s become a common life-saving procedure for people like me,” said Fatima, who did not have a suitable living donor in the family and had to wait for a deceased donor.
BMC is empanelled into the National Center for Regulating Donation and Transplantation of Human Organs and Tissues. Fatima underwent a pre-liver transplant evaluation and was on the waitlist for six months.
“All cirrhotic livers are prone to primary liver cancer. Fatima developed liver cancer a year ago. However, we could not perform surgical resection as she had advanced decompensated cirrhosis with portal hypertension. She wouldn’t tolerate a liver resection,” said Dr Rehan.
“We used a TACE (Trans Arterial Chemo Embolisation) procedure to control the cancer while waiting for the transplant. Later, another part of her liver developed a second cancer. It was controlled using another TACE procedure to prevent the cancer from spreading beyond the liver and to ensure that her disease would remain within the criteria to be eligible for a liver transplant.”
‘Extremely challenging surgery’
Following the confirmation from the organ transplant team, the doctors went ahead with organ retrieval first and then the liver transplant surgery.
The transplant was led by Dr Rehan, accompanied by Dr Johns Mathew, a specialist in gastrointestinal surgery; Dr Ramamurthy Baskaran, consultant anaesthesiology and transplant anaesthesia; Dr Mohamed Mourad Hashim, consultant and head anaesthesiology; and Dr Ahmed Omran, consultant, anaesthesia; Dr Nicholas Wyon, consultant critical care medicine, and Dr Ahmed Mansy, specialist – ICU.
A multi-disciplinary effort by the medical team, including the nursing and rehabilitation teams, the administrative team, the transplant manager, the transplant coordinator, and a social worker, led to the success of the procedure.
According to Dr Rehan, the surgery was extremely challenging.
“The surgery was complex mainly due to the degree of portal hypertension, which makes the removal of the diseased liver difficult. It posed a high risk of severe bleeding. However, we achieved it safely with minimal blood loss of 500ml. Only one unit of blood transfusion was required during the procedure,” said Dr Rehan.
Fatima is recovering well with a healthy functioning liver graft.
“I’ve been receiving appropriate treatment for pain and rehabilitation, making good progress in respect of my diet tolerance,” said Fatima.
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