BY LILLIAM RIERA —Granma International staff writer—

THE first liver transplant in a Cuban pediatric hospital has been performed by a team of specialists from the William Soler Hospital in Havana on a 13-year-old girl from the eastern province of Granma, suffering from hepatic cirrhosis for which a transplant is the only treatment option.

Hepatic cirrhosis causes normal liver cells to be progressively replaced by scar tissue (fibrosis), which gradually reduces the function of this important organ.

Twenty-six days have passed since Yusleidis Montoya Maceo’s surgery. Her parents are confident that she will soon be returning to the city of Bayamo, as are her relatives and friends who have constantly written to her with their wishes for a speedy recovery.

Reporters from Granma International found her sitting beside her bed and in good spirits, in the company of her father and nurse Alina Rodríguez.

"I feel fine and am very happy," she said, going on to tell us that although she had to spend her birthday in the hospital (June 16), the doctors gave her gifts and she blew out candles on a cake, but she couldn’t eat it, given that it was so soon after surgery.

Yusleidis’ father, who works as a coachman in Bayamo, and Maira, her mother, who is a housewife, expressed appreciation and satisfaction at the results of the surgery and had nothing but praise for the medical team headed by Dr. Ramón Villamil Martínez that is attending the young girl, as well as for the nurses and general workers at the hospital, the Revolution and Fidel, "for having saved our daughter’s life," they affirmed.

Both consider the treatment Yusleidis has received to be professionally "excellent" and humanly "marvelous."

According to the recollections of doctors and nurses, the child arrived at the hospital in very poor condition, with a distended abdomen, no appetite, and a distinct yellowish green coloring. Yusleidis is another person after undergoing the complex operation, which in Cuba is performed free of charge, in contrast to other countries where such surgery can cost hundreds of millions of dollars.

Dr. Villamil feels that the girl is recovering "very satisfactorily." Her liver functions are normal, her original coloring has come back, her abdomen has reduced in size; she has a good appetite and can walk around the hospital unaided.

Previous liver transplants on children have been performed at the Hermanos Ameijeiras Surgical Clinic and the Medical-Surgical Research Center (CIMEQ).

In CIMEQ, for example, around 100 such transplants have been performed on children and adults with a survival rate comparable to world institutions more advanced in these procedures, despite the difficulties caused by the U.S. blockade.

Of all the transplants done from July 1999 to October 2005, on patients whose age ranged between 12 and 62, nine have received a second transplant and two have undergone a combined liver and kidney transplant.

CIMEQ specialists say that the principal reason for this type of operation in adults is hepatic cirrhosis produced by the hepatitis C virus, alcohol consumption and liver failure, while in children, the causes are biliary atresia and secondary biliary cirrhosis.

According to Granma, Dr. Luis Orlando Rodríguez, director of the William Soler Hospital, commented on the expertise transferred by the physicians of Ameijeiras and CIMEQ in order to make those new advances at his institute, as well as the support received from the Cuban National Coordination of Transplants, the Maternal-Infant ward, the William Soler Hospital Cardio Center, pediatricians Juan Manuel Márquez and Angel Arturo Aballí, and the 10 de Octubre Surgical Clinic.

Dr. Villamil, for his part, praised the generous solidarity of many Cuban families who have donated the organs of their loved ones killed in accidents in order to save the lives of others.

The head of the team that operated on Yusleidis told Granma International that with the realization of this first liver transplant at William Soler Hospital, the institution has now become the site for the Children’s Liver Transplant Program, which will allow, in the near future, the development of pediatric transplants in general.

Liver transplants are considered the most complex of all including heart transplants. In children these transplants are seen as even more difficult given the microsurgical procedures that must be used, the level of care necessary before, during and after, and the scarcity of donor organs.

Nevertheless, the use of advanced techniques and anti-rejection drugs have contributed to raising the life expectancy rate of these patients, which at the dawning of the 21st century has no fixed limit.

Cuba’s Liver Transplant Development Program, headquartered at CIMEQ, began July 1999 as the result of a collaboration agreement with the Spanish Virgen del Rocío Hospital.

This program has been affected by instability of supplies, since many of the components used are produced in the United States and the authorities of that country will not give Cuba permission to buy them or simply prolong the necessary paperwork indefinitely.

Members of the multidisciplinary team that operated on Yusleidis commented that the Abbot Laboratories in the United States never responded to Cuba’s request to purchase a device, exclusively produced by the company, which is indispensable for monitoring blood levels in child patients in need of liver transplants. Variations in that parameter can cause complications such as infections or secondary tumors.

A report presented by Cuba to the UN General Assembly in 2005 calculated the damage caused by the U.S. blockade in its public health sector at $75.7 million. This figure does not include the incalculable suffering inflicted on people due to the lack of medicines, equipment and disposable materials in facilities throughout the country.