The liver is a remarkable organ.
“It can take a lot of insult and injury,” Dr. John LaMattina, a transplant specialist at the University of Maryland Medical Center.”
The problem however is that “there are simply not enough livers to support the need of recipients in the world and the U.S., the eastern part of the U.S. in particular,” LaMattina said. “Only about half the people that need of a liver transplant – or that would benefit from a liver transplant – make it to the liver transplant [surgery].”
LaMattina is one of three surgeons at the medical center who specializes in living donor organ transplantation. Surgeons basically cut a liver in half and plant the healthy organ in a sick person.
“We essentially have to create two lives out of one liver,” LaMattina.
The implanted liver will re-grow to healthy size in about three weeks. Like we said, remarkable.
“And we’re able to take advantage of the phenomenon,” LaMattina added.
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Living donor transplantation has grown since the late 80s when doctors began testing taking organs from parents and surgically implanting them into their children. The procedure gradually expanded to accommodate a transplant from a large person to a small person and most recently from one normal sized person to another.
Doctors believe the procedure is a solution to the constant shortage of livers globally. LaMattina said roughly 17,000 patients are on lists to receive a liver every day, but only between 5,000 and 6,000 surgeries are scheduled annually. The average wait time for the organ is about 14 months.
“In the past 20 years, that has provided the impetus for health care and for surgeons to say what else can we offer these critically ill patients who are dying, [by the] thousands every year,” LaMattina said.
“The waiting list isn’t static,” LaMattina continued. “It’s changing all the time. People are being added to the list every minute of every day and people are being taken off the list every minute every day.”
Alarmingly, living donor transplant may expand – although it is hard to say specifically – to address a growing health issue nationwide.
In Baltimore, doctors find most patients requiring a liver suffer from Hepatitis C or chronic alcoholism, which cause cirrhosis or a scaring of the organ. But a surge in fatty liver disease has become the emerging concern of the health care community and readers are likely contributing to it right now, reading this article.
“The health care community thinks is from the sedentary American lifestyle. That’s becoming sort of the next big epidemic,” LaMattina said.
A little over a month ago, Charles Hughes was lying in a hospital bed recovering from a liver transplant. Cirrhosis of the liver killed his father. But thanks to the generosity of a woman he had known for 25 years, Hughes said he’s now considering skydiving.
"This whole ordeal changed my life and made me look at things a lot different and appreciate what you have in life, because it might not be here tomorrow," Hughes said.
The procedure is one of the more technically demanding surgeries that doctors perform. There are about 100 hospitals that can perform liver transplants across the U.S., but only about 30 can perform living donor transplants.
“We are committed to trying to do things every year better than the previous year because there is such a need,” said Dr. Rolf Barth, director of liver transplantation at the University of Maryland Medical Center. “We are reminded of that every day when we see patients in the hospital. We’ve been using that as motivation.”
The hospital recorded 108 liver transplants in the last fiscal year. Barth said his team is on track to complete 120 this year.