TMC Performs Landmark Liver Transplant

The Medical City announced its landmark achievement of the first successful pediatric liver transplant surgery performed in the country by an all-Filipino team. The patient is three-year-old Catherine Erica Buenaventura, who was diagnosed with end-stage liver disease complicated by portal hypertension, or an increase in blood pressure in a system of veins within the stomach, intestine, spleen and pancreas. Additionally, Erica suffered from malnutrition and bleeding in the veins around the esophagus, both of which are complications of portal hypertension. The donor is her 18-year-old uncle Jefferson Llantino, who is a first cousin of Erica’s mother Carmela.

Two operations took place simultaneously on January 7. Erica’s diseased liver was removed entirely, after which she received a graft which was taken from her uncle’s liver. The procedure started at 7 am on January 7 and ended during the early morning hours of January 8. Erica remained in TMC’S Pediatric Intensive Care Unit (ICU) for the first eight days after surgery, and was then moved to a regular room on Sunday, January 16. Her condition is stable and her “new” liver is functioning well. Jefferson has recovered fully, and was discharged from the hospital on January 14.

Dr. Ma. Vanessa H. De Villa, a liver transplant surgeon who has worked in some of the best transplant centers in the world, headed the transplant team composed of highly qualified, internationally-trained experts covering multidisciplinary surgical and medical fields. The surgical
team included hepatobiliary and liver transplant surgeons Dr. Allan Concejero, Dr. Dante Ang and Dr. Anthony Yap; plastic and reconstructive/microsurgery surgeons Dr. Eric Arcilla and Dr. Catherine Asedillo; and anesthesiologists Drs. Grace Herbosa, Celine Ancheta, Alexandra Odi, Elena Malong, Elke Sauz and Rolan Carreon . The medical team was composed of pediatric gastroenterologists Drs. Karen Calixto-Mercado and Jean Guno, and adult hepatologists Drs. Janus Ong and Eternity Labio. Pediatric intensivists Dr. Maria Victoria Samonte and Dr. Neva Batayola attended to Erica in the pediatric ICU. The other specialists involved in Erica’s care are infectious disease physicians Dr.
Cynthia Aguirre and Regina Berba, pediatric cardiologists Dr. Dexter Cheng, radiologist Dr. Romel Galsim, pathologist and TMC Blood Bank head Dr. Lourdes Concepcion, developmental pediatrician Dr. Stella Manalo, and rehabilitation specialist Dr. Celso Bate. During the operation and throughout her stay in the ICU and the step-down unit, Erica’s doctors have been ably assisted by a specialized team of some 50 professionals from nursing, laboratory, radiology, pharmacy, nutrition and physical therapy departments.

Dr. De Villa’s colleagues from the Queen Mary Hospital of Hong Kong University – Dr. Chung Mau Lo, Head of the Hepatobiliary, Pancreatic and Liver Transplant Surgery Division; and Plastic and Reconstructive and Head and Neck surgeon Raymond Ng – were likewise on-hand to observe the Filipino surgical team at work.

Liver disease is a common problem in the country, affecting adults and children alike. Among adults, chronic hepatitis B infection, alcoholic liver disease, and nonalcoholic fatty liver disease are the most common liver ailments. One in five of those with these diseases develop complications such as liver cirrhosis, liver failure and liver cancer. Biliary atresia is a disease of the bile ducts that affects 1 in 15,000 children. The majority develop cirrhosis and liver failure as well. For most of these patients with severe complications of liver disease, the only option is liver transplantation or liver replacement surgery. Unfortunately, the Philippines has lagged other countries in this area of intervention.

Thus, many Filipinos have been forced to go abroad to undergo liver transplantation, enduring long travel to and isolation in a foreign land, while having to spend large amounts for transport and accommodations, in addition to the costs of care.

TMC established the Center for Liver Disease Management and Transplantation (CLDMT) in response to this tremendous gap in the local healthcare industry. Headed by Dr. De Villa, the CLDMT is a comprehensive liver center that offers patients the seamless integration of medical, surgical and radiologic expertise in the delivery of an extensive array of state-of-the-art diagnostic and
therapeutic services for the management of liver disease.

“Due to the limited treatment options available in the various medical centers in the Philippines, many people with liver conditions have in the past chosen to leave the country to seek treatment abroad,” said Dr. De Villa. “Now that we have proven that we can do successful liver transplants at The Medical City, we can offer our patients in the Philippines the same world-class quality health care that overseas liver centers provide.”

Erica’s transplant is the culmination of four years of preparation by the hospital, involving substantial investments in facilities, equipment and capacity-building of doctors and nurses.

“As with all our undertakings, we took up this challenge for broader and larger national purpose. This transplant surgery raises the standards of healthcare not only at The Medical City but in the entire country.” said Dr. Alfredo R. A. Bengzon, TMC President and CEO. “Our success is living proof of the excellence of the Filipino health professional and Filipino healthcare institution.”

Dr. Bengzon also cited the Philippine Charities and Sweepstakes Office for the significant support it provided for Erica’s treatment. “This signifies the start of a more substantial and productive partnership between PCSO and TMC in ensuring equitable access to quality healthcare for our countrymen,” Dr. Bengzon added.