BRAVE LOGAN'S A REAL FIGHTER; Toddler is able to eat for first time after op.

Byline: Greg Tindle

LITTLE Logan Donegan is able to eat for the first time, thanks to a pioneering transplant operation, the first on a Welsh child.

The seriously ill 23-month-old from the Rhymney Valley was born with part of his bowel outside his body and has spent most of his young life in hospital.

But now, after a delicate 12-hour operation to replace his small and large intestine with that of a three-year-old donor, he is at last able to taste soft foods including yoghurt and Marmite.

Logan's operation was carried out at the Birmingham Children's Hospital and his mother Rhian is keeping her fingers crossed the transplant will prove a success.

Logan's medical problems were first discovered when Rhian had an ultrasound scan during pregnancy. The scan showed that her baby had a rare problem called gastroschisis, where part of the bowel grows outside the body. It affects around three babies in every 10,000.

After he was born Logan underwent seven operations within six months - three of them in the first four days of his life - to try to correct the problem.

But doctors decided earlier this summer that a complete transplant was the only alternative left.

Rhian, 21, of Aberbargoed, described Logan as being "fine at the moment", but said there is still a long way to go because the brave toddler has other serious health problems and is also likely to need a liver transplant within the next few months.

Rhian said the extent of Logan's medical problems had been difficult to take in, but said the support from her mum Debbie and dad Derek had helped her to deal with the daily anxiety caused by his long stints in hospital.

"When he was born I was told he would probably be in hospital for four to six weeks," she said. "But he ended up in the Children's Hospital for Wales in Cardiff for nine months until he eventually came home.

"But after that he was in and out of the hospital all the time and my parents and I took eight-hour turns to be at his bedside day and night.

"I eventually knew he needed a transplant but when the call came it was at 5am on July 10 and we were taken by ambulance to Birmingham and by midday he was in the operating theatre. It's still all a bit of dream, it was so rushed but thankfully that didn't give us time to get worried."

Rhian said that after his seven operations on his bowel Logan had only 23 centimetres left of his original intestines, about a quarter of what he was born with, and this was replaced by the transplant.

She explained that when he was born in October 2007 doctors gave him a slim chance of survival.

"It was all very difficult to take in. My mum, who had come with me, was in pieces. I had quite a normal pregnancy up to then. It didn't really sink in for me.

"It was my first pregnancy so it didn't even enter my mind that there would be something wrong.

"But I thought it would be just a straightforward procedure. When the baby was born, I was told he would probably be in hospital for around four to six weeks after his birth.

"But Logan is such a fighter. He has been unable to eat anything up to now but after the transplant he can now eat yoghurt, and likes the taste of Marmite, but nothing solid. The main thing is that he's putting on weight and since the transplant has gone up from 10 kilos to nearly 14 kilos which is a good sign."

But to ensure that the transplant is not rejected Logan is on 13 forms of medication each day.

He has made "loads of improvement" according to Rhian, but the next stage in a hoped for recovery is another trip to the Birmingham Children's Hospital next week when Logan will undergo a biopsy in advance of a possible liver transplant to deal with disease in the organ.

Dr Ieuan Davies, who has cared for Logan since his birth, said: "Most babies who were born with this condition simply have their intestines put back with a series of operations and that works very well.

"But with Logan his gut was abnormal to begin with so he could not tolerate any food at all. But since then, and with the care of his mother and grandparents, he has done fantastically well.

"They are a remarkable family and the support they have shown this child has been tremendous. Rhian herself has learned to care for Logan, picking up some very complicated skills which are as good as a specialist nurse's. I cannot give them enough praise for what they are doing for this toddler."

A spokeswoman for the Birmingham Children's Hospital confirmed that Logan was the first child from Wales to have the transplant: "This is a very rare operation and in the past 10 years we have performed just 68 similar operations on children from all across the UK but our records show that Logan was the first from Wales."

LITTLE LOGAN'S OPERATION After a suitable donor was found Logan and mum Rhian were taken by ambulance from their home Aberbargoed to Birmingham Children's Hospital at 5.30am on July 10.

After an initial assessment Logan was on the operating theatre table at 1.30pm where surgeons opened up his stomach and took out the last remaining section of his small and large intestine which had not functioned since his birth, despite seven previous operations.

Surgeons then worked against the clock, having only a four-hour window to transplant the donor intestines, replacing Logan's remaining and diseased 23 centimetres of gut with a normal sized bowel of 60 centimetres.

The surgeons spent a majority of their time stitching and joining up the new bowel inside Logan, something which was made more complicated by the amount of scar tissue from previous surgery.

Surgeons then also installed a special stoma tube which will take the waste from Logan's bowel for about the next three years and until his bowel is able to function properly.

After the operation Logan spent the following 24 hours under sedation in the hospitals's intensive care unit.

He was then moved to a High Dependency Unit where he stayed for the following four weeks before being allowed home.

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23-month-old Logan's operation at Birmingham Children's Hospital took 12 hours Rhian Donegan and toddler Logan, from the Rhymney Valley, who has undergone a rarely performed intestine transplant operation PICTURES: Wales News Service