Woman ‘Critical’ After First Liver Transplant at UCSD

A middle-aged San Diego woman received a new liver Monday in the first such transplant under a new UC San Diego Medical Center program.

The recipient, a mother of five children ages 10 to 23, requested that her age and name not be released. She was reported in critical condition Monday night.

Doctors said they were optimistic after the transplant but would not know until today whether the procedure was successful.

At a press conference after the 10-hour operation, Paul I. Jagger, the center’s medical director, said it will be six months before “we know whether all the immunological factors are going well,” and whether the organ would be rejected.

The recipient, who had been waiting about three months for a liver, is a Medi-Cal patient who cannot afford the operation. The average cost of a liver transplant is $160,000. UCSD decided to fund the first transplant as part of the “start-up” of its program.

Medi-Cal will not fund the procedure until 10 transplants have been done in the new program.

A team of 16 doctors and nurses led by Dr. Oscar Bronsther worked on the transplant, including 10 surgeons involved in harvesting and transplanting the liver.

The liver became available Sunday night, and doctors picked it up in Bakersfield at midnight.

The operation began at 5:50 a.m. Monday, ended at 4 p.m. and required 10 units of blood, Jagger said. The amount, he said, was “on the low side. In some cases with complications, as much as 100 units have been used.”

The recipient, who was the hospital’s “first bona fide candidate,” was in good health when she entered surgery, Jagger said.

“The patient was felt to be a reasonable risk,” he said. “She was in good condition. She had a fatal disease, but she was not in a terminal condition.”

The new program was the subject of controversy after medical politics helped end a liver transplant program at Sharp Memorial Hospital in 1984. The Sharp program, headed by UCSD Medical Center Prof. Marshall Orloff, was sharply criticized for losing five out of six patients from late 1983 to early 1984.

Jagger said he could not comment on the Sharp program but did say the potential risk of the operation has diminished in the past several years because of new immunocological medicine to help prevent rejection.

“It has made quite a difference, and it was just becoming available when Sharp was doing operations,” he said.

UCSD Medical Center began planning the transplant program year years ago, Jagger said, and a committee began looking for a candidate about six months ago.

He said the hospital is planning six months ahead and hopes to do one transplant a month. The next recipient has not been chosen. The center already has a successful kidney transplant program.