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First-ever "domino" liver transplant performed

MIAMI: Doctors at the University of Miami Medical Centre said on Friday they had performed the first so-called "domino" liver transplant, in which the healthy liver of a patient receiving a multi-organ transplant was used to save the life of a second person.

In the procedure, performed on April 11 but publicised only on Friday, the healthy liver of a 17-year-old Pennsylvania girl who underwent the transplant of several organs was given to a second patient, a woman who was near death with liver failure.

The two transplants were performed at the same time, in a measure that doctors said offered a real chance to make the best use of the limited supply of donor organs that become available each year.

In southern Florida alone, there are some 150 people now on waiting lists for liver transplants, and hundreds of others await other organs such as kidneys, hearts and lungs. There are more than 45,000 patients on the national transplant waiting list, with some 2,000 more added each month.

"Domino liver transplantation can utilize organs that would otherwise be wasted and maximize the benefits of modern technology for the greatest good," said Dr Andreas Tzakis, chief of the division of liver and gastrointestinal transplantation at the University of Miami Medical School.

Seventeen-year-old Rondie Harris of Reading, Pennsylvania, had been unable to eat normally since birth because of a severe digestive disorder that kept her body from properly absorbing nutrients. Her condition had become so bad that doctors decided to attempt a multi-organ transplant.

But when a block of donor organs became available, they were from a younger child, which meant it would have been more complicated to attach the new organs to Harris' larger liver. By transplanting the liver, small and large intestines, stomach and pancreas as a block, the surgeons had to make fewer delicate connections, said Tzkis, who led the team that performed the transplants.

"The way the entire graft (block of organs) was transplanted, these connections were already made and we only had to connect to her body two vessels rather than several," he said.

He also noted transplant experts believe that transplanting the liver along with the block of other organs lessens the chances that the recipient's body will reject the new organ.

Tzakis said Harris, who spoke to reporters on Friday, was doing well. She is out of intensive care and has been able to eat. The other patient, a woman who has not been identified, received only Harris' liver, and remains in intensive care although Tzakis said she also has done reasonably well since the operation.

Harris, a high school junior, who spoke from her hospital bed, looked pale and was shaking as she gave interviews, but said she felt good and felt excited to have been part of a big advancement in transplants. "I didn't know how big, but now I do," she said.

Doctors in Britain have performed successful "domino" heart transplants, in which a new heart and lungs were transplanted into lung disease sufferers, whose healthy hearts were then given to other patients.

Doctors timed Friday's announcement, during the period declared National Organ & Tissue Donor Awareness Week, to highlight the fact that thousands of people die in the United States each year while waiting for organs to become available for transplant.-Reuter