Identical twins undergo rare liver transplants at Indraprastha Apollo Hospital
Last month, 23-month-old identical twin brothers from the Philippines underwent two complex living-donor liver transplants at Indraprastha Apollo Hospital in Delhi to treat a rare, life-threatening congenital liver disorder. The toddlers, Kelly and Tyler, were suffering from Choledochal Cyst Type IVA, which causes abnormal enlargement of the bile ducts and leads to progressive liver failure.
The surgeries, performed a week apart, required liver donations from the twins' family members after their father, Wilson, was found medically unfit to donate. Their mother, Daisy Ann, donated a portion of her liver to one twin, while their maternal uncle donated part of his liver to the other.
According to doctors, the condition affects about one in 1 lakh children, with Type IVA accounting for less than 10 percent of those cases. Dr. Anupam Sibal, group medical director and senior paediatric gastroenterologist at Apollo Hospitals, stated that it is extraordinarily uncommon for identical twins to both present with this rare subtype requiring transplantation. Unlike other forms of the disease, where surgery can often correct the abnormality, Type IVA affects the bile ducts within the liver itself, making transplantation the only definitive treatment once liver failure develops.
Each transplant lasted over 10 hours. Dr. Neerav Goyal, senior consultant and head of liver transplant surgery, explained that the twins were anatomically almost identical, meaning their CT scans mirrored each other. Operating on the second child presented the same anatomical challenges as the first, with diseased bile ducts densely stuck to surrounding organs and blood vessels requiring delicate reconstruction. Surgeons removed the children’s diseased livers before implanting reduced portions of the healthy donor livers, which were small enough to fit inside the abdomen of a toddler.
The twins have recovered well, are playing like healthy toddlers, and are preparing to return home to the Philippines. Daisy Ann shared that the children's health issues began at four months of age, leading them to seek treatment in India as liver transplants are not conducted in the Philippines. The treatment cost between Rs 18 lakh and Rs 25 lakh for each child.
