3 Year-Old Kid Saved From Biliary Atresia Through The Medical City, DOH, PCMC Partnership | The Medical City

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3 Year-Old Kid Saved From Biliary Atresia Through The Medical City, DOH, PCMC Partnership

By The Medical City (TMC), Ortigas | April 19, 2024

Through the collaboration between The Medical City, the Department of Health, and the Philippine Children's Medical Center, Gianna was able to receive a liver transplant that saved her life. This was made possible through the Pediatric Access to Liver Transplant (PAsLiT) Program, which has now successfully treated its second patient.


It all began with a mother's intuition.

Jennifer Visto, a 38-year-old mother of four from Antipolo, noticed a slight yellowish tinge to the skin of her youngest child, Gianna, at just two weeks old. While she could have dismissed it as a passing phase, Jennifer felt a strong urge to understand what was happening with her youngest.

It was 2021, and everyone was still grappling with the pandemic. Despite the logistical hurdles in the country, Jennifer and her family were determined to seek clarity from Gianna's medical condition.  

Initially, one doctor suggested that Gianna might have G6PD (glucose-6-phosphate dehydrogenase) deficiency, a genetic disorder resulting from insufficient levels of the G6PD enzyme, crucial for red blood cell function. Symptoms of G6PD may include jaundice, characterized by yellowing of the skin and eyes.

Yet, Jennifer sensed there was more to Gianna's condition. She requested further tests to assess her daughter's liver health, which revealed abnormalities in her liver and bile ducts. This confirmed that her youngest daughter has biliary atresia.

“Sobrang bigat po, parang gumuho po yung mundo ko nung sinabi ng doctor na possible biliary atresia [ang diagnosis kay Gianna]. Hindi ko naisip na mangyayari sa amin yung nakikita ko lang sa social media, sa news feed mo na mga batang may sakit at nanghihingi ng tulong yung mga magulang,” Jennifer shared. 

["The weight of it all was immense. It felt as though my world collapsed when the doctor mentioned the possibility of biliary atresia for Gianna's diagnosis. I never imagined that what I saw only in social media and news feeds—children battling illnesses while their parents seek help—would become our reality," Jennifer shared.]


Biliary Atresia

Biliary atresia is a rare liver disease that occurs in infants. It involves the inflammation, obstruction, or absence of the bile ducts inside or outside the liver. Bile ducts are essential for the drainage of bile, which aids in the digestion of fats. When these ducts are blocked or absent, bile builds up in the liver, causing damage and scarring (cirrhosis) over time.

The exact cause of biliary atresia is unknown, but it's believed to involve a combination of genetic and environmental factors. Symptoms typically appear within the first few weeks to months of life and may include jaundice (yellowing of the skin and eyes), dark urine, pale stools, enlarged liver or spleen, and poor weight gain.

Biliary atresia requires prompt diagnosis and treatment to prevent liver damage and failure. One temporary treatment for biliary atresia is surgery called the Kasai procedure, which involves removing the damaged bile ducts and attaching the small intestine directly to the liver to allow bile to drain. However, even with Kasai, many infants with biliary atresia eventually require a liver transplant later in life due to ongoing liver damage.

This is true for Gianna’s case. Before turning 3 months old, she underwent the Kasai procedure. However, her doctors then recommended that she undergo a liver transplant immediately. 

Desperate for answers and support, Jennifer resorted to joining online groups of parents whose children are afflicted with the same disease as Gianna. 

“Bilang nanay, search ka nang search. Naghanap ako ng mga groups. Sila yung nag guide sa akin kung ano gagawin kasi wala akong alam, wala akong idea, hanggang search lang ako,” she said.

[“As a worried mother, you will really search for answers. I looked for online groups. They guided me on how to navigate this situation, because I really didn’t have any idea about it. I can only look for answers online at that time.”]

A group of parents suggested the idea of going to India to save Gianna's life. However, they were informed they needed Php 500,000 to undergo the procedure in India. Jennifer knew they couldn't raise such a substantial amount right away. Consequently, despite initial reservations, she turned to the government for assistance.

Jennifer's outreach led her to the Philippine Children’s Medical Center (PCMC), which then introduced her to the Pediatric Access to Liver Transplant (PAsLiT) Program. PASLIT, born from a consortium among the Department of Health, PCMC, and The Medical City (TMC), aims to support pediatric patients needing liver transplants, in line with the nationwide expansion of healthcare services mandated by Republic Act 11463, also known as the Malasakit Center Act of 2019.

TMC is the preferred medical facility for the program due to its renowned success in treating liver diseases, particularly through its Center for Liver Health and Transplantation (CLHT).

After a thorough evaluation, Gianna was deemed eligible to receive treatment under the program by August 2023. Jennifer is the qualified donor for her youngest daughter. However, the family faced several hurdles before Gianna could undergo the transplant.

“Marami mga naging delays. Kinailangan ko pang mag undergo ng TB treatment. On and off ang fever ni baby. Ang dami kong questions, para sa anak ko ba yung liver transplant? Lalo na kasi hindi naman as worse yung condition nya compared sa ibang bata kasi nakatulong yung Kasai operation nya. Tinatanong ko yung sarili ko kung para sa amin ba talaga, pero sabi ko na lang, si Lord na ang bahala.”

[“There were delays along the way. I had to undergo treatment for Tuberculosis. Gianna was also having fever every once in a while. It led me to question if the liver transplant is really for my child, especially since her condition isn’t as worse compared to other kids–thanks to the Kasai procedure. But I just surrendered to the Lord.”]


Finally, on February 23, 2024, Jeniffer and Gianna underwent a liver transplant at TMC. A few days after the transplant, Gianna stayed at the Intensive Care Unit for a few days and was closely monitored by a team of doctors, who made sure that Gianna is at an optimal state before transitioning her to a regular room.  

Initially doubting the government program, it dawned on Jennifer after the operation that Gianna’s life was saved through PASLIT. 

“Salamat po sa lahat ng naging instrumento–itong PASLIT Program, mga doctors ni Gianna; lahat ng sambayanan, lahat ng Pilipino, may part sila doon kasi galing sa tax ng taumbayan yung pinagkuhaan ng pondo. Kaya sobrang salamat talaga na nagkaroon ng ganung program ang government, PCMC, at TMC. Hindi ko akalain na mapapasama kami, pangalawa pa lang po kami sa beneficiaries,” Jennifer shared with tears of joy in her eyes. 

[“Thank you to everyone who became an instrument—the PASLIT Program, Gianna’s doctors, the Filipino people also played a part here because the funds come from their taxes. I’m really grateful that the government, PCMC, and TMC have a program like this. I didn’t expect that we will be one of the recipients, and we’re just the second one.”]

Gianna's discharge on March 22 marked the beginning of a new chapter, made possible by the opportunities afforded by the PASLIT Program. Jennifer couldn’t wait to witness all the milestones that her youngest child will be able to achieve.

“Excited and blessed, ‘Yun po yung nararamdaman ko. Excited na magiging normal na sya. Mararanasan nya yung ganda ng mundo. Kahit maraming pagsubok dito, deserve nya po mabuhay,” Jennifer shared.

“Hindi man po namin deserve, kaming magulang, yung mga blessings kasi habang nandito tayo sa mundong ito patuloy tayong magkakasala, at sobrang bait lang po ni Lord kasi na-bless nya po kami at alam ko pong deserve ng anak kong mabuhay. Deserve nya yung pagmamahal na kailangan nya,” she added. 

[“I feel excited and blessed. I’m excited that Gianna will have a normal life now. She’ll be able to experience the beauty of the world. Even if there are a lot of challenges, she deserves to live,” Jennifer shared.

“We, as her parents, might not deserve all these blessings, especially because we will continue to sin as long as we’re living, but the Lord is just gracious because He blessed us. And, I know that my daughter deserves to live. She deserves to be given all the love she needs,” she added.]


TMC’s Center for Liver Health and Transplantation

TMC’s CLHT was established in 2008. Guided by its innovative equipment and multi-specialty group of healthcare professionals, it has successfully operated 15 pediatric patients and 10 adult patients. Dr. Vanessa de Villa, a hepatobiliary surgeon, and a pioneering liver transplant specialist, championed the first successful pediatric liver transplantation surgery in 2011.

Gianna is the second beneficiary of the PASLIT Program since its inception. 

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