A two-and-a-half-year-old boy from Kingston, Wash., became the region’s first recipient of a living-related split-liver transplant on Wednesday, July 21 in a coordinated surgery performed by transplant teams from University of Washington Medical Center and Children’s Hospital and Regional Medical Center. His mother, Wendy Richards, was the donor.
Children’s patient Coe Richards received the left lobe of his mother’s liver. As a normal course following transplant surgery, Coe is in critical condition in Children’s Intensive Care Unit (ICU) where a special transplant team is caring for him. The average stay in the ICU following a transplant is one to two weeks. Once he is stabilized, he will be transferred to a regular inpatient unit.
The surgeries started at 9 a.m. yesterday with mother Wendy Richards at UW Medical Center. Dr. James Perkins, chief of transplant surgery at UW Medical Center and Children’s Hospital, took a portion of Wendy’s liver. From UW Medical Center, it was transported to Children’s Hospital, where Dr. Patrick Healey, attending transplant and pediatric surgeon, performed a liver transplant on Coe.
In December 1998, Coe was diagnosed at Children’s with a hepatoblastoma (liver tumor). The first course of treatment included six months of chemotherapy to shrink the tumor. Exploratory surgery was attempted in the hope of removing the entire tumor, but because of its location and condition, doctors decided instead to perform a liver transplant.
Because no cadaveric liver was available on the local and national United Network for Organ Sharing (UNOS) lists, Coe’s only recourse was a living-related split-liver transplant.
“This collaboration is possible because the transplant divisions at UW Medical Center and Children?s Hospital are in fact a single division under the auspices of the UW School of Medicine. It is because of this structure that we are able to maintain excellent cooperation between our two teams,” said Perkins.
The University of Washington Transplantation Program has become a recognized leader in transplant services in the Pacific Northwest. University of Washington Medical Center is a primary teaching hospital for the UW School of Medicine, the only medical school for the Washington, Wyoming, Alaska, Montana and Idaho (WWAMI) region. It is licensed as a 450-bed comprehensive care facility. The nearly 400 attending physicians on staff are full-time faculty members of the UW School of Medicine. It is is both a regional referral and treatment center for specialized medical care and a provider of comprehensive primary care services for Greater Seattle residents, with more than 80 outpatient clinics and multidisciplinary specialty centers.
Children’s is the only pediatric-based transplant center in the Pacific Northwest where the region’s children can receive kidney, liver, and heart transplants as part of the comprehensive transplant program offered at the UW. Children’s first liver transplant was performed in 1990. As both a community hospital for greater Seattle and the pediatric referral center for the Pacific Northwest, Children’s provides, directly or in partnership with others, excellent pediatric care, education, and research programs.
Facts on Living-Donor Liver Transplants
Two operations are performed in a living-donor liver transplant. The first involves removal of the smaller left lobe of the living donor’s liver. That portion is transplanted into the organ recipient.
The first living-donor liver transplant was performed in November, 1989 at the University of Chicago Hospitals.
In 1998, the latest year for which figures are available from UNOS, approximately 66 living-donor transplants were performed in the United States. There have been 40-60 of these transplant surgeries performed each year over the past five years.
Facts on Liver Transplantation at UW Medical Center and Children’s Hospital
Dr. James Perkins is director of the Transplantation Program at both institutions. The first adult liver transplant at UW Medical Center was performed in January 1990. Children’s first pediatric liver transplant was performed later that year.
To date, 493 liver transplants have been performed at UWMC and 47 liver transplants have been performed at Children’s. In 1998, 57 liver transplants were performed at UW Medical Center.
The survival rate for liver transplants at UWMC is almost 84 percent. The overall survival rate for liver transplants at Children’s is 78 percent.
Approximately 196 patients are on the waiting list for a liver transplant at UW Medical Center. Approximately 13 patients are on the waiting list at Children’s.
UW Medical Center and Oregon Health Sciences University are the only medical centers to offer adult liver transplants in a five-state region including Washington, Oregon, Idaho, Montana, and Alaska.
Children’s has the only pediatric-based transplant center in the Pacific Northwest, offering kidney, liver, and heart transplants.
The University of Washington Transplantation Program has become a recognized leader in transplant services in the Pacific Northwest, offering kidney, heart, liver, pancreas, and lung transplants. Last year, transplants at UWMC included 26 hearts, 12 lungs, 57 livers, 69 kidneys, 22 kidney-pancreas, and three pancreas, as well as two bone marrow transplants and 60 autologous blood stem cell transplants.
In an effort to increase the availability of donor cadaveric livers, UWMC and Children’s are now offering split-liver transplantation, where a single donor liver is divided into two transplantable liver grafts. This is an effort that could save more than 20 lives each year in the Pacific Northwest. The expansion is possible due to improvements in the technique for removing livers from donors.
As of July 9, 1999, there were 13,376 patients waiting for liver transplants in the U.S. A total of 4,450 liver transplants were performed in 1998.