Baby gets on-again, off-again chance at new life

By MARTIN JOHNSTON, health reporter

Fourteen-month-old Brady Anderson is set to become the youngest person to have a liver transplant in New Zealand - once surgeons can squeeze him on to surgery lists clogged up by the radiographers' strikes.

He will also be the first child in the country to receive a portion of liver from a living donor, his grandmother.

The first liver transplant from a living donor was in September at the country's only liver transplant unit, at Auckland Hospital. The donor and recipient, who are adult siblings, are recovering well.

Brady's transplant was planned for this month, but has been cancelled twice because of the industrial action by 90 Auckland District Health Board radiographers.

Their union called off the strikes on Wednesday, as the board agreed to independent arbitration of the pay dispute.

But Brady will probably have to wait until January for the transplant while surgeons struggle to catch up on postponed operations.

He was put on a waiting list in May to receive a liver from a braindead donor, but has still not reached the top of the list of 12 patients, partly because New Zealand has too fewdonors.

Brady's 54-year-old grandmother, who asked to be known only as Suzanne, said she offered to be his donor because she could not stand by and watch him have no chance at life.

"Just being a grandmother, your heart goes out and all you want to do ishelp."

A quarter of her liver will be transplanted into Brady in the risky operation.

Brady's liver has been faulty since birth because of a rare condition called biliary atresia, in which there are insufficient ducts to drain bile. His liver is just able to keep him alive, but is not working well enough for him to grow and develop normally.

He has jaundice, cannot crawl and has to receive most of his food through a nose tube to his stomach.

The liver is the body's chemical factory. In a living-donor transplant, the sections in both patients grow back to normal size in about six weeks.

Brady was in a stable but serious condition, said Associate Professor John McCall, the Auckland Hospital surgeon who will remove the liver portion from Suzanne for colleague Professor Stephen Munn to put into Brady.

The little boy would eventually die without the operation, said Professor McCall.

"At any time he could develop a complication of his liver disease such as bleeding or infection.

"These are potentially fatal complications ... "

But if the transplant is successful, he should catch up on his growth and development.

Brady was born in Texas. His parents, Helen and Grant Anderson, decided to return to New Zealand because Brady needed a transplant - which their American insurers refused to pay for - and for the support of family and friends.

Mrs Anderson said Brady was a happy child, but the jaundice made him itchy so he slept badly and a distended stomach from his enlarged liver and spleen left him unable to crawl.

Suzanne said changes were needed to the organ-donation system, under which people could indicate on their driving licence that they wished to become a donor, but that wish could be overridden by family after their death.

Organs are donated from about 40 people a year nationwide after deaths from accidents and other causes, which is low by international standards.

About 15 per cent of patients on the liver-transplant list die while waiting and the median wait is six months.

National Party health spokeswoman Lynda Scott said that before people had "donor" printed on their licences, they should go through an informed-consent process, with family involvement. That should increase the number of organs available.

Herald feature: Health