Sivojit in his mother’s arms in Delhi on Wednesday. Picture by Ramakant Kushwaha

New Delhi, Oct. 8: The yellow hue in her infant’s face and eyes has vanished, giving way to toothless smiles, and Munmun Paul is getting used to the happy antics of her seven-month old Sivojit.

The infant from Calcutta, born with a structural defect that destroyed his liver, has become India’s youngest recipient of a liver transplant after a 16-hour surgery by doctors at the Apollo Indraprastha Hospital here.

Transplant surgeon Subash Gupta and his colleagues removed a chunk of liver — about the size of an adult human fist — from the infant’s father, Indrajit Paul, and implanted it into Sivojit’s abdomen.

Doctors today declared the transplant procedure — performed on September 8 — successful. Indrajit is already back at work and the mother and child could go home in a week, they said.

The boy’s battle against liver failure and a community-driven contributory social security mechanism in Calcutta that helped bring about his operation, doctors say, could also serve as models for other patients and other cities.

“We’d never seen this baby smile — until about two weeks after the transplant,” said Gupta, senior consultant and liver transplant specialist at the Apollo Hospital. “It was an emotional moment to see those first smiles.”

“This isn’t the way he was before the operation,” Munmun said. “He was irritable and cried a lot. Now he smiles and is like any other baby.”

Sivojit had been born with a condition called biliary atresia, a condition in which a duct linking the liver to the small intestine is missing. It affects about one in 12,000 babies across the world.

An operation to create a link between the two organs was done in Calcutta, but Sivojit’s condition continued to deteriorate. “We were in a dilemma when he first arrived here,” said Anupal Sibal, senior pediatric gastroenterologist at Apollo.

“A liver transplant is ideally performed after a child is at least one year of age. But he continued to deteriorate rapidly, his bilirubin levels continued to climb,” Sibal said. The high bilirubin was making Sivojit lethargic and he refused to take any feed.

Investigations revealed that the father would be an appropriate liver donor. The removal of a part of the liver poses no harm to a donor because the organ has the capacity to regenerate fully within eight to 12 weeks.

Research from other countries suggests that about 80 per cent of liver transplant recipients are alive about 10 years after surgery. After discharge, Sivojit will need medicines that cost about Rs 6,000 each month, doctors said.

In the past, younger children — including a 19-day-old infant — have received liver transplants outside India. Doctors are hoping Sivojit’s case would spur other parents in India in similar situations into action.

“In such cases, parents often give up in despair — particularly when the treatment appears out of reach. But Sivojit has a lesson for us all. We can win even when things appear really bad,” said Abhijit Chowdhury, a hepatologist and the secretary of Liver Foundation, Bengal, a non-government organisation that helped raise part of the funds for the transplant.

The family — Indrajit is a lawyer — stumped up money but not enough to cover the entire expense.

While Sivojit was in Apollo for the transplant procedure, tabla player Bickram Ghosh and vocalist Lopamudra Mitra performed in Calcutta — three hours of music to facilitate a 16-hour operation.

Chowdhury contacted Apollo’s Gupta — with whom he had collaborated earlier for research on liver disease — and set into motion what he calls a “contributory social security” mechanism, seeking funds for the liver transplant procedure that can cost Rs 22 lakh-Rs 25 lakh.

Apollo agreed to do the operation for Rs 12 lakh, Chowdhury said.