Contact: Ellen Bank
843.792.2626
Nov. 15, 2000
CHARLESTON, S.C. -- A four-year-old girl, Elizabeth Walter, received a living related liver transplant at the Medical University of South Carolina Nov. 6. The donor was her father, Todd Walter, M.D., a 34-year-old family physician from the Upstate.
The child had been in normal health until two weeks ago when she had a viral syndrome and was noted to be jaundiced. She subsequently was admitted to the Greenville Memorial Hospital with liver failure and developed mental status changes and was transferred to the Children's Hospital at MUSC in South Carolina for consideration of a liver transplant. The child was listed for a liver transplant within 24 hours of arrival and as her mental status deteriorated, no organ was available.
The father was evaluated and found to have a compatible blood type and anatomy which was suitable for being a living donor. The seven-hour surgery was performed to remove the left part of his liver and this was subsequently reconstructed and transplanted into the child. The donor and recipient operations each lasted close to seven hours and were performed by a multi-disciplinary team of surgeons, anesthesiologists, nurses, and coordinators to mention a few. The father did not receive any blood products and was discharged from the hospital five days after the surgery. The child is recovering and with normal liver function.
Living related liver transplantation was first developed in Japan where there are no cadaver organs. In this country, it was first initiated in Chicago approximately ten years ago. Currently, there are approximately 30 centers which perform this type of surgery.
The liver, in many ways, is the ideal organ for live donation, because the organ can regenerate completely within a few weeks after a lobe has been removed. Unlike other donated organs, such as the kidney, which are totally removed, the liver can regenerate to its full size as long as it is a normal liver. The same happens to the recipient when the liver adjusts itself to the size of the recipient. The biggest advantage of live donation is to provide a liver in time before the recipient gets too sick and to allow optimal success after liver transplantation. Success is entirely dependent upon the status or how sick the recipient is pre-transplant. There is no advantage from a rejection standpoint in live liver donation.
The biggest concern has been in smaller children, where there is a 15 to 20 percent incidence of Hepatic Artery Thrombosis (HAT) that in the best of hands. An early thrombosis would require that the child be re-transplanted. It is fortunate that both the donor and recipient surgery in this case went very smoothly and had an excellent result.
The MUSC Transplant Center performs about 65 liver transplants per year. Organ donation in this state has improved significantly over the last two years and in this particular case, time was of the essence and a suitable cadaveric organ was not available in a short period of time.
#####