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Living Donor Liver Transplants Improved Outcome Using New Technique

The University of Alberta Hospital is one of only a few centers in Canada that performs living donor liver transplants, a surgical procedure developed in the late 1980s that expands the organ donor pool. About 80 liver transplants are done a year in Alberta, 10 of those being living-donors. All potential liver transplant donors are assessed based on considerations such as the size and composition of the liver and vascular and bile duct anatomy. Thanks to a review paper done at the University of Alberta radiologists at the (UAH) are now using CT (Computed Tomography) imaging for living-donor liver transplantation. This technique shows relevant liver anatomy and, in particular, enhances high resolution imaging of the vital bile duct anatomy. CT scans provide a clear image of the important ducts doctors need to see. In the past radiologists have only been using an MRI to scan possible donors for bile duct anatomy. By using CT imaging the results are much more accurate and reliable for the surgeons. Right now possible donors are screened with both MRI and CT scans. The hope is to one day only use CT imaging; adding "All-in-one" imaging will speed up the process and make living-donor evaluation more convenient for potential donors. * As many as four patients are evaluated by CT imaging every month.
35 Responses
Avatar universal
You are so very welcome beautiful lady. And I do mean beautiful!!   (((HUGS)))
Avatar universal
Gosh, I don't know why? Do you think you may have some stress. Silly, silly girl. I love you, and I am praying for you! Take care sweetheart! ~Kande
Avatar universal
This info brings back memories of my days as a living doner.  In 2003 I donated part of my liver to my aunt.  The one test I will never forget was the MRI.  It is good to see that technology will make the process a lot easier.  The living donor surgery experience was hard, but it was worth all the pain because I now see my aunt playing with her grandchildren.  In 2003 she was given months to live without a donor.  Five years later she is going strong.

Leslie
Avatar universal
Hi iona1,
           Yes iona I imagine you did suffer a lot after the donor surgery. You went through the samething I did, the surgery is the same. How wonderful you are to give the gift of life! There is no greater gift you can give. I am so glad your aunt is doing well, and grandchildren...what a blessing! Much love to you! Thank you for posting this. :o)  ~Kande  (((HUGS)))
Avatar universal
http://news.bbc.co.uk/1/hi/scotland/edinburgh_and_east/7269659.stm

Is a "living" donor transplant better IF a patient does have someone that is able to donate as iona did for her Aunt? That was really nice of you iona. Your Aunt knows she is loved - that's for sure.

I think I read somewhere that Type O blood (thats what I have) is hardest for transplant, but I can't remember why they said that or even if I have the information correct. I probably read when I was first dx with hep - so I don't really remember. I should look it up, but I have to run out for a few minutes.

MO
Avatar universal
Ps,,,,I know it's better as far as not having to wait but does it have its advantages for the patient - health wise?
Avatar universal
It does not really matter whether the doner is living or not, as to the viability of the organ.  The problem is that there are not a lot of organs available when the patient needs it.  My aunt was placed on the national donor list, however she was far down on the list.  In order to move up, she would have to be gravely ill and just hope a liver would be available at that time.  With a "Living" donor, the liver is available now as long as the donor passes the many tests.  

As for the blood type, I am also type O.  Type O blood is hardest because someone with O type can only receive O type blood.  On the other hand Type O is good to have as a donor.

Avatar universal
Hi sweetie,
                As far as the patient is concerned, I would say yes. For several reasons, a better match, and as you said, no waiting period. But for the donor it can be difficult. As iona said there is pain and sometimes there are complications. Doctors have been known to take too much of the donors liver, causing problems. It can be risky. But I believe most cases are successful. In Indy they now do living donor transplants all the time with great success. I wouldn't be afraid to donate. As for the O-type blood, I never heard that before...something to research. I believe all blood is the same, you just need a matching donor. The only thing that would be difficult would be the need for a rare blood type, such as A-type blood. I think! I will do some research on this for you. Thanks sweetheart.  (((HUGS)))  ~Kande
Avatar universal
Girl, I see you got that one! You are fast! Nice to have you here, hang around! (((HUGS)))  ~Kande  :o)
Avatar universal
Hey iona, Is O-type blood rare? I have O-positive, and it is the most common. My significant other has A-type so he couldn't donate to me. He wanted to but just couldn't.  But I love the fact that he wanted to. :o)  ~Kande
Avatar universal
You must have a blood type compatible with the recipient or you will not be able to donate. Here is who can donate to whom:

Type A can donate to types A and AB.

Type B can donate to types B and AB.
  
Type AB can donate to type AB.
    
Type O can donate to types A, B, AB, and O.
Avatar universal
Really?! I am O positive and my donor would have been A negative. The doctors said no way. Is it the positive and negative that got in the way? Thanks  ~Kande
Avatar universal
Whether you are O positive or negative, the only person who can donate is type O.  This is what makes having type O tough when you need blood.  We can donate to everyone, but can't receive from everyone.

As for my presence today in this forum, I have been participating in the Ovarian Cancer forum for the past year because my mother was diagnosed last summer.  My eye just caught transplatation and I thought I could be of encouragement to others since I have experienced it, just as the members in the Ovarian Cancer forum have been to me during my mothers illness.


Avatar universal
You have been a big help! Thanks! So sorry to hear about your mother. I lost my mother to cancer years ago, she was only 52. :(     (((HUGS)))    ~Kande
Avatar universal
From The American Red Cross

What are the different types of blood? (Top)
Blood comes in different types. Each person has a specific ABO type (A, B, AB, 0) and RH factor (positive or negative). Nearly half of all the blood ordered by hospitals is Type 0 negative.
  
The most prevalent types of blood are 0 positive and A positive. The least common types are B negative and AB negative. Only fifteen percent of the population is negative for the RH factor.
  
Type 0 negative donors are always in demand because their blood can be safely transfused to patients of all blood types, making them "universal donors."
  
For example, a premature baby's life can depend on a transfusion of 0 negative blood because the usual cross-matching and blood-typing procedures may not be possible. Or in an emergency, a patient may need a transfusion immediately, with no time to cross-match blood. Often, the patient receives type 0 negative blood until the emergency is over and the patient is stable.
  
Patients with any of the positive blood types can safely receive type 0 positive blood.
  
Here is a breakdown of different blood types and their uses: Prevalence of Blood Type
AB Neg. .6% 1 in 167
B Neg. 1.5%  1 in 67
AB Pos.  3.4%  1 in 29
A Neg.  6.3%  1 in 16
0 Neg.  6.6%  1 in 15
B Pos.  8.5%  1 in 12
A Pos.  35.7%  1 in 3  
0 Pos.  37.4%  1 in 3
  
Possible Transfusion Combinations
Blood Type Can be given to patients with type
0+ 0+, A+, B+, AB+  
A+  A+, AB+  
B+ B+, AB+
AB+ AB+  
0- 0+, A+, B+, AB+, 0- , A- , -B , AB-  
A- A+, AB+, A- , AB-  
B- B+, AB+, B- , AB-  
AB- AB+, AB-  


My Ex was 0- THE RAREST blood AND CAN DONATE TO ALL
Dan
Avatar universal
Correction not the rarest but it can be donated to all
Sorry
D
Avatar universal
Blood Type Can receive liver from: Generally can donate a liver to:
O                        O                               O, A, B, AB
A                       A, O                              A, AB
B                       B, O                              B, AB
AB                     O, A, B, AB                         AB
Avatar universal
Thanks for the info, but now I am getting confused. I have to read it all again.


iona said "Type O blood is hardest because someone with O type can only receive O type blood.  On the other hand Type O is good to have as a donor. "

Thats what I think I remember reading.

MO


Avatar universal
Donor blood type compatibility for blood transfusion is a distinctly different issue than donor blood type compatibility for liver transplantation. I was type AB and I could have gotten a liver from anyone - maybe even a baboon - a small baboon, that is. Mike
Avatar universal
I was just going to ask that! I wish I would have asked before I posted it. I bet I wouldn't have to brush your shoes anymore than!
Avatar universal
before I posted it
-------------------------------
before YOU posted it.
Avatar universal
Really
Wow i stand corrected and maybe i should have looked better. You would know and i will look more. Still learning. Maybe i should just watch from now on..
D
Avatar universal
Maybe i should just watch from now on..
-------------------------------------------------------------------
Dan, mistakes never stopped me!! LOL Read my posts in the archives.Don't worry about it, mike has seen us all make bloopers - he is getting easier on us when we make boo boo's.

MO
Avatar universal
From: http://en.wikipedia.org/wiki/Blood_type

"Red blood cell compatibility

    * Blood group AB individuals have both A and B antigens on the surface of their RBCs, and their blood serum does not contain any antibodies against either A or B antigen. Therefore, an individual with type AB blood can receive blood from any group (with AB being preferable), but can donate blood only to another group AB individual.
    * Blood group A individuals have the A antigen on the surface of their RBCs, and blood serum containing IgM antibodies against the B antigen. Therefore, a group A individual can receive blood only from individuals of groups A or O (with A being preferable), and can donate blood to individuals with type A or AB.
    * Blood group B individuals have the B antigen on the surface of their RBCs, and blood serum containing IgM antibodies against the A antigen. Therefore, a group B individual can receive blood only from individuals of groups B or O (with B being preferable), and can donate blood to individuals with type B or AB.
    * Blood group O (or blood group zero in some countries) individuals do not have either A or B antigens on the surface of their RBCs, but their blood serum contains IgM anti-A antibodies and anti-B antibodies against the A and B blood group antigens. Therefore, a group O individual can receive blood only from a group O individual, but can donate blood to individuals of any ABO blood group (ie A, B, O or AB). If anyone needs a blood transfusion in a dire emergency, and if the time taken to process the recipient's blood would cause a detrimental delay, O Negative blood can be issued.

Plasma compatibility
Recipients can receive plasma of the same blood group, but otherwise the donor-recipient compatibility for blood plasma is the converse of that of RBCs: plasma extracted from type AB blood can be transfused to individuals of any blood group; individuals of blood group O can receive plasma from any blood group; and type O plasma can be used only by type O recipients.

Universal donors and universal recipients

With regard to transfusions of whole blood or packed red blood cells, individuals with type O negative blood are often called universal donors, and those with type AB positive blood are called universal recipients (Strictly speaking this is not true and individuals with Hh antigen system (also known as the Bombay blood group) are the universal donors[citation needed]). Although blood donors with particularly strong anti-A, anti-B or any atypical blood group antibody are excluded from blood donation, the terms universal donor and universal recipient are an over-simplification, because they only consider possible reactions of the recipient's anti-A and anti-B antibodies to transfused red blood cells, and also possible sensitisation to RhD antigens. The possible reactions of anti-A and anti-B antibodies present in the transfused blood to the recipients RBCs are not considered, because a relatively small volume of plasma containing antibodies is transfused.

    By way of example; considering the transfusion of O RhD negative blood (universal donor blood) into a recipient of blood group A RhD positive, an immune reaction between the recipient's anti-B antibodies and the transfused RBCs is not anticipated. However, the relatively small amount of plasma in the transfused blood contains anti-A antibodies, which could react with the A antigens on the surface of the recipients RBCs, but a significant reaction is unlikely because of the dilution factors. Rhesus D sensitisization is not anticipated.

Additionally, red blood cell surface antigens other than A, B and Rh D, might cause adverse reactions and sensitization, if they can bind to the corresponding antibodies to generate an immune response. Transfusions are further complicated because platelets and white blood cells (WBCs) have their own systems of surface antigens, and sensitization to platelet or WBC antigens can occur as a result of transfusion.

Conversion

In April 2007 a method was discovered to convert blood types A, B, and AB to O, using enzymes. This method is still experimental and the resulting blood has yet to undergo human trials.[37][38] The method specifically removes or converts antigens on the red blood cells, so other antigens and antibodies would remain. This does not help plasma compatibility, but that is a lesser concern since plasma has much more limited clinical utility in transfusion and is much easier to preserve.
With regard to transfusions of plasma, this situation is reversed. Type O plasma can be given only to O recipients, while AB plasma (which does not contain anti-A or anti-B antibodies) can be given to patients of any ABO blood group."

Complicated enough?

Mike
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