Noel Joshua Selvanathan, a 36-year-old service staff member, underwent a significant lifestyle transformation to become a living liver donor for his three-year-old son, Isaiah, who suffers from Aliagille syndrome, a rare genetic disorder affecting the liver’s bile ducts. The condition causes bile to accumulate in the liver, leading to severe liver damage and failure if untreated.

Isaiah was diagnosed with worsening liver failure shortly after birth, and doctors determined that a liver transplant was his best chance for survival. Given the scarcity of donor organs in Singapore, patients often face a waiting period ranging from 12 to 22 months for a deceased donor liver. Because of this, many turn to living donor liver transplants, where a compatible family member donates a portion of their liver, reducing wait times significantly.

Initially, Noel was unable to donate due to his history of hepatitis C, fatty liver disease, and prior struggles with substance and alcohol abuse. His wife, Melissa Orchard, had volunteered but was ruled out after doctors discovered lesions and a tumor on her spleen, necessitating its removal and making her ineligible to donate.

Motivated by his son's critical condition, Noel committed to overhauling his lifestyle. He underwent treatment to eradicate hepatitis C and committed to a strict regimen of weight loss, dietary changes, and regular exercise to reverse his fatty liver disease. He also abstained entirely from alcohol. After several months and medical clearance confirming his liver was healthy, Noel was deemed a suitable donor.

The transplant surgery took place on March 26 at the National University Hospital (NUH) in Singapore. Led by Vidyadhar Mali, surgical director of the Paediatric Kidney and Liver Transplantation Programmes, the operation involved a coordinated effort between pediatric and adult liver transplant surgeons. Noel’s liver segment was removed by transplant surgeon Pang Ning Qi, while pediatric surgeons Dale Loh and Vidyadhar Mali simultaneously performed the transplant in Isaiah. The teams operated in connected theaters, facilitating continuous communication throughout the 12-hour procedure.

The transplant was successful, with surgeons noting the restored liver’s healthy coloration and function shortly after implantation, confirmed by Doppler ultrasound monitoring of blood flow through the portal vein.

Since the transplant, Isaiah has shown remarkable improvement. Previously frail and jaundiced, he is now an active and curious toddler closely monitored by the NUH medical team to manage potential rejection risks, particularly within the first year post-transplant.

For Noel, the experience has prompted a lasting commitment to health and well-being. He continues to maintain his new lifestyle, including regular exercise and dietary restrictions, underscoring his dedication to his family’s future. Melissa Orchard expressed deep gratitude to the medical team for their vital role in guiding them through this challenging period.