Living Donor’s Liver Enhances Survival : Medicine: Eight years after surgeons first implanted a portion of an adult’s liver in an infant, doctors say the procedure is successful about 90% of the time. That contrasts with an 80% success rate for cadaver transplants.
A baby diagnosed with liver disease can’t be cured with medicine, doctors say. Without a new organ, most infants with problem livers will die.
Doctors facing a severe shortage of transplants for children began experimenting with living donors. Surgeons take a piece of liver from a healthy person and implant it in a sick baby. The baby’s new liver grows with the child; the donor’s liver regenerates.
Eight years after the first procedure was performed in Brazil, doctors say the living-donor procedure is proving successful about 90% of the time. That compares to an 80% success rate for cadaver transplants.
“Some people say you are putting perfectly healthy human beings at risk by taking their liver,” said Esther Benenson, spokeswoman for the United Network for Organ Sharing. “On the other hand, does somebody have the right to tell a parent he or she cannot take extraordinary means to save their child?”
The first living donor liver transplant in the United States was performed in November, 1989. Today, the recipient, Alyssa Smith, is a happy first-grader in suburban San Antonio.
About 150 living donor operations have been performed in the United States, and about 350 worldwide, said Dr. James Piper, director of the University of Chicago Hospitals’ liver transplant program.
About a dozen U.S. hospitals have performed the living donor operations, which can last up to 15 hours, Benenson said.
Six-month-old Tanisha Hunt of Reading, Pa., was on the donor list for two months when her family decided it could no longer wait. Her father, Richard, donated a section of his liver to Tanisha on Nov. 14 at St. Christopher’s Hospital for Children in Philadelphia.
They are both home and doing well, said Carol Norris, a hospital spokeswoman.
As of the first of the year, 4,059 people were waiting for liver transplants in the United States, including 289 children under age 5 and a total of 531 youngsters under age 18.
Ten percent of children who need liver transplants die while waiting for a donated organ, said Dr. Stephen Dunn, director of the kidney and liver transplant program at St. Christopher’s.
“These are some of the sickest kids that ever come into the hospital,” Dunn said.
The portion of liver taken from the donor depends on the size of the recipient, Piper said. Twenty percent of the donor liver is taken for a baby, 40% for an older child, he said.
Only one donor death has been reported, in Germany, but the risks are very real, Piper said.
Japan has performed transplants on some smaller adults. Chicago has approval to operate on adults, but none has been performed so far.
United Network for Organ Sharing in Richmond, Va., said the liver is second to the kidney as the most requested organ. Unlike kidney disease, which can be treated with dialysis, liver disease cannot be treated.
“You can’t wait for a liver,” Benenson said. “Gradually you will die if you don’t get a transplant.”
