An 11-year-old girl from Iraq with progressive liver disease secondary to Wilson disease underwent a complex living donor liver transplant in Gurugram after developing advanced hepatic complications despite medical management. The child had experienced recurrent jaundice, weakness, and fatigue for nearly a year. Her condition subsequently progressed to advanced liver failure, hepatic encephalopathy, and impaired blood clotting. With further deterioration despite treatment in Iraq, she was referred to India for transplant evaluation. Assessment at a private hospital in Gurugram confirmed advanced liver disease requiring transplantation.

A family member was evaluated and found suitable as a living donor. The recipient underwent transplantation using a left lobe graft incorporating the middle hepatic vein. Intraoperatively, the liver was enlarged and nodular, with ascites also noted. The…