Chennai toddler survives ECMO following bone marrow transplant

When he was six-week-old, the child was diagnosed with the rare bowel disease due to IL-10 R deficiency. The only available treatment was to do an early bone marrow transplant.

With financial support from Tamil Nadu Chief Minister’s fund, the bone marrow transplant was performed at Rainbow Children’s Hospital when he was five months old. But the crisis was far from over, as he then suffered severe complications causing damage to kidneys, liver, heart and lungs on the 14th day of transplant. The baby had also suffered cardiac arrest within short duration of arrival to hospital.

Doctors said that children who undergo this transplant do not survive ECMO. The ECMO team led by Dr Karthik Narayanan, senior consultant, Paediatric Intensive Care, said the echo of his heart revealed that the child had a huge clot obstructing blood flow which probably resulted in the heart to stop suddenly. The blood clot was dissolved after starting appropriate medicines.

After that, the baby required ECMO for the next 20 days. After 20 days, the child was de-cannulated and later dialysis followed by plasma exchange was stopped.

According to the ELSO registry, an international registry for outcomes of patients on ECMO, only eight children who underwent bone marrow transplant till date have been offered ECMO – all of them in the US and UK – and not many of them survived. However, after following up the case of a year, doctors here said the neurological outcome was good and the child could regain development and lead a normal life.