Yale-New Haven Hospital Performs First Split Liver Transplant

Liver Transplant

Yale-New Haven Hospital reached an organ transplantation milestone, with the successful transplant of a split liver harvested from a donor in Boston. The eight-hour procedure was performed by Sukru Emre, M.D., the new director of the Yale-New Haven Transplantation Center (YNHTC). It was the first split liver transplant in Connecticut.

The recipient was 7-month old Sebastian Rovira from Isabela, Puerto Rico. He received the small section of the adult liver which replaced his own failing liver due to a condition called biliary atresia, the most common reason for pediatric liver transplants. About 25 percent of the donated liver was transplanted into Rovira; the rest of the liver went to an adult patient elsewhere. Split liver transplants allow more patients to share to scarce supply of donated livers.

Dr. Emre also performs living donor liver transplantation, in which a family member (such as a parent, sibling or child) or an unrelated donor (such as a spouse) donates part of his/her liver for transplantation in both adult and children with end stage liver disease. Both split and living donor liver transplantations are important leading edge surgeries to increase number of available donors and save more lives.

"The liver is a remarkable organ, and the only organ we have available to us in transplantation that is capable of regeneration," said Dr. Emre. "We are able to take a small section of liver from the donor and connect the blood vessels, the bile ducts and all the very intricate connections that require sutures smaller than a human hair. The liver will then grow as the child grows into adulthood. The patient will still need to be on immunosuppressant medications throughout his life, but the liver not only provides a new life, but a quality of life." When a portion of a liver is taken from living donors, their liver grows back to its original size within 6 to 8 weeks after donation.

Yale-New Haven Hospital was a pioneer in transplantation, performing Connecticut's first cornea transplant in 1952; kidney transplant in 1967; liver transplant in 1983; and heart transplant in 1984. In addition, YNHH also performed the state's first bone marrow transplant in 1988; heart-lung transplant in 1988; pancreas transplant in 1989; single lung in 1990; and a successful heart transplant from an unmatched donor in 1992.

According to the United Network for Organ Sharing, nearly 98,000 Americans are awaiting organ transplants, with almost 17,000 seeking livers. About 1 in 10,000 infants are born each year with biliary atresia.

Liver disease may remain asymptomatic for a long time. Eventually, acute or chronic liver disease becomes evident with jaundice, ascitis, cachexia, extreme fatigue and damage to other organs, such as brain, kidney, lung, and heart. At this point, only liver transplantation can be life saving. In addition, an increasing number of patients develop liver cancer. For some, liver transplantation represents the best treatment.

Yale-New Haven Transplantation Center offers liver, kidney, kidney/pancreas and pancreas transplantation, including innovative treatments and access to research trials for patients suffering from a wide range of conditions. Yale-New Haven Hospital serves patients from Connecticut, New York, New Jersey and throughout New England, and is a major referral center for other transplant programs faced with particularly challenging cases. YNHH is one of a few transplantation centers with a dedicated transplant ICU to provide specialized care to post-surgery patients. In addition, YNHH has a dedicated outpatient treatment center and inpatient service for coordinated, comprehensive evaluation, testing and follow-up care.