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In a UMC first, liver is shared by 2 recipients This was done in Tu...
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In a UMC first, liver is shared by 2 recipients This was done in Tucson

The lives of two Arizonans - a tiny baby and a full-grown man - have been saved by the first split-liver transplant ever performed at University Medical Center.

The rare transplant surgery gave one-third of a donor liver to 6-month-old Maria Lara-Neri of Phoenix and the remaining two-thirds to Rocky Steely, 51, of Sierra Vista.

Both patients were suffering end-stage liver disease at the time of the transplant, performed in back-to-back surgeries by UMC's new abdominal transplant team on July 20 and 21. Neither patient would have survived without the shared liver from the unidentified deceased donor, doctors say.

Unlike all other major solid organs, the liver has the ability to regenerate itself, meaning segments of it can regrow to full size. That makes it possible for two patients to share a single donor liver - a great advantage in the face of the huge shortage of donor organs today.

"Donated organs are so rare and so precious," said Dr. Ernesto Molmenti, chief of UMC's abdominal transplant program, who performed the double transplant with UA surgery chief Dr. Hugo Villar.

"There are so many people waiting for an organ," Molmenti said. "To see two people returned to health in a split-liver transplant doubles the gift of life. It's a privilege to do this work."

Baby Maria was so close to death at the time of the transplant that doctors almost were forced to cancel her surgery. Her liver was destroyed by a genetic disorder known as biliary atresia, which damages the tiny ducts connecting the liver to the small intestine.

"The little girl's situation before the transplant was very dire," Molmenti said. "She was essentially dying. At times, we had to remove her from the transplant list because it didn't look like she could survive the surgery. But she rallied, and this perfect liver came at just the right time."

Maria is in stable condition at UMC and is expected to leave the hospital at the end of this week or early next week, Molmenti said. She and her parents will live close to UMC for several weeks so she can attend post-transplant clinics there before the family returns to Phoenix.

Also in the last stages of liver failure was the baby's transplant partner, Steely, whose liver was ruined by a 30-year battle with hepatitis C, a viral disease. His situation at the time of the transplant was not as critical as Maria's, but a new liver also was his only hope for survival.

"It had gotten to the point where I spent almost half of the last three months in the hospital," Steely said. "I had always been told I would probably need a transplant eventually, and I finally got to that point.

Steely returned home to Sierra Vista on Thursday.

He said he had some concern about the split-liver procedure when he first heard about it.

"But I knew I had to take the chance. This is not something you can put off," he said.

He came through the transplant without complications and now is working to regain his strength.

"It's like taking your first baby steps," he said.

Still quite rare, only six split-liver transplants - including this first one at UMC - have ever been performed in Arizona, out of a total of 722 liver transplants statewide since 1988. Four split livers have occurred at the Mayo Clinic in Scottsdale, and one was done at Banner Good Samaritan Medical Center in Phoenix.

As with the UMC transplant, the donor livers were shared between an adult and a child. However, the liver segments harvested by Mayo and Good Samaritan were flown to children in California because UMC is the only Arizona hospital now performing pediatric liver transplants.

The complex operation is considerably more challenging than a standard liver transplant because of the difficulty of dividing the donor liver.

"You have to transect the liver while it is still in the donor, so the blood is still flowing," said Molmenti, who performed about 20 split-liver transplants before coming to UMC a year ago from Johns Hopkins University Medical School in Baltimore.

"That's a major procedure in itself. The challenge is to divide the liver into unequal pieces while preserving its blood supply and biliary drainage."

At this point, the liver segments have grown "significantly" in both patients and are expected to expand to full size within months, he said.

Calling this unusual operation "a milestone," UMC Chief Executive Officer Gregory Pivirotto pointed out that it's not just UMC's first split-liver transplant but also the hospital's first pediatric liver transplant.

Molmenti was recruited to launch UMC's abdominal transplant program last year. That has meant significantly expanding the ongoing kidney transplant program, now including children, and restarting the defunct liver and pancreas transplant programs, also offering new livers to children.

The fledgling program has performed 16 kidney transplants so far this year, along with three liver transplants and one pancreas transplant.


Facts on donation of livers

To become an organ  

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2 Comments Post a Comment
Wow!!!  That's it, just wow!!!
love to hear stories like that, i think that thier should be more live liver transplants being done also...
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