“Alive with a New, Old Liver”
In recognition of February being Organ Donor Awareness Month, we share an inspiring story from the New York Times.
When you think about organ donation, you may think about the prospect of donating organs after a loved one’s (or your own) untimely death. Or perhaps you may be familiar with living donor organ donation, in which a benevolent healthy donor gives a kidney or a portion of their liver to allow someone to undergo a lifesaving transplant.
The February 3, 2014 Well column in the New York Times highlighted yet another way in which organ donation can save lives. The column tells the story of Jonathan Nunez, an 8-year-old boy who underwent a very special type of liver transplantation by Tomoaki Kato, MD, Surgical Director of Liver and Abdominal Transplantation.
Jonathan’s transplant, called auxiliary partial orthotopic liver transplantation (APOLT), is a unique type of surgery in which part of his failing liver was left in place when he received his new liver. Because the liver has the capability to regenerate, his native liver had the chance to heal while the new healthy tissue handled his body’s essential functions.
The hope was that with this support, Jonathan’s original liver would heal. And in his case, as in virtually all the other children Dr. Kato has transplanted, it worked.
According to Dr. Kato, “When the failing liver recovers, the child can stop taking the powerful immunosuppressant drugs that are required after transplant surgery. The donated portion of liver will wither and die, leaving the child with a healthy liver and medication-free once again.”
APOLT, also called partial liver transplantation, is appropriate for some children with acute liver failure. It is not appropriate for chronic liver failure, and it does not work as well in adults. As a result, few surgeons in the country have extensive experience with it.
Dr. Kato, one of the highest regarded pediatric transplant surgeons in the U.S. and a pioneer of creative approaches to liver and intestinal transplantation, has performed APOLT in 13 children. Twelve of the 13 children’s native livers have recovered so far, allowing them to stop taking immunosuppressant medications and live normal lives.
Videos of Dr. Kato explaining liver and intestinal transplantation are also available in the Center for Liver Disease and Transplantation.