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The three daughters of a 38-year-old housewife, Ninivalda Pereira Macedo, needed a liver transplant. After periods of waiting and anxiety, all three were successful. Born with a genetic condition that compromises the functioning of the organ, girls, ages 15, 12 and 10, must be kept healthy to wait for a compatible donor.
This is the first case of liver transplantation in more than two siblings, in patients with progressive familial intrahepatic cholestasis, performed at the Children's Institute of the United States. Clínicas Hospital of the Faculty of Medicine of the University of São Paulo
Lindalva Macedo dos Santos, 15, was born with the disease, which causes an accumulation of bile in the liver, compromising the functioning of l & # 39; organ. When she was two years old, she was ill and was taken to a basic health unit (UBS) in the eastern part of the capital. "The doctor said that it was serious and she was referred to Menino Jesus Hospital and then to the Hospital das Clínicas." At the age of two, she did the tail. "
When children need a liver transplant, parents are usually donors, but girls did not have this option." In children, between 80% and 90% grafts are done with the gift of the father or mother through the transplant, when a piece of liver is removed and transplanted. In this case, there was a particular characteristic. Parents could not be donors because of genetic and clinical problems, "says Uenis Tannuri, chief of pediatric surgery and liver transplantation at the Instituto da Criança
while Lindalva was 8 years old in 2010. "It was a long operation that stirred a lot at home, but I was not afraid that my other daughters would have the problem because they were born healthy," says the mother.
The following year, the daughter of Ninivalda, Juliana Macedo dos Santos, now 12 years old, began to be accompanied by the department of hepatology of the hospital. She had itching since the age of 2 years and it is this symptom that helped her diagnosis. "They had different symptoms, he could tell Lindalva by the swelling of his belly, Juliana started with an itch, there were people who said it was food allergy, But it was nothing like that, she did the exams and had the diagnosis.The doctor has already warned that he should have a transplant. "
So, again a Once, the family was found online to try to get an organ for another girl. While waiting, in 2015, Priscila Macedo dos Santos, now 10 years old, began to show a yellowish color, an indication that liver function is not doing well.
In September 2016, the matching donor appeared for Juliana. She spent more than two months in the hospital, and Priscilla got worse at that time. "She had a haemorrhage when Juliana was hospitalized and lost a lot of blood," said the father of the girls, Mason Joelson Pereira dos Santos, 42 years old.
Priscila was able to receive the organ in March of this year. . The three still have a medication routine: the youngest takes ten medications and the eldest, one, but leads a normal life. Lindalva and Juliana go to school, and the youngest daughter is expected to return to school after this year's holidays.
Even facing hospital visits for examinations and hospitalizations, the family has the family room decorated with pictures of young women. . These are recordings in different phases of their lives, but in none of them do they look like a sick person. What differs from the people of their age today is the story of the struggle for life and the diet that they follow. "It must be a food without salt and without fat, but they are well," says Ninivalda
Relief
Santos is relieved by the fact that all three have managed to graft themselves and not to hide gratitude for the medical team. "I just want God to turn on those doctors, if it was not for them, my daughters would not be here, sometimes we felt defeated, there were a lot of ups and downs, and that was all. is something we have the trauma of talking about, but it's a story of conquering and winning. "
Dr. Tannuri, also professor of the discipline of pediatric surgery and liver transplantation department of pediatrics at the FMUSP, says that the case of the three sisters was a "multiplied challenge".
"I saw this kind of case with two brothers, but it was the first we had with three.I'm from the beginning of the program.Our commitment was to control the girls so that we It is a beautiful thing for the joy of seeing the three sisters survive and to be an accomplished act in a public hospital. "Transplants
Currently, Of the 33,154 people waiting for a transplant in the country, 1,289 are waiting for a liver, according to the Ministry of Health.Health In 2017, there was a 12.1% increase in liver transplants by compared to 2016 and a 15.9% increase in procedures with living donors.The information comes from the newspaper O Estado de S. Paulo
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