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Living-Donor Transplants - The Gift of Life


WebMD Health News
Reviewed by Gary D. Vogin, MD

Feb. 6, 2002 -- Juanita Chavez and her sister Maria Elena were always very close. But until last year, neither could have imagined that one of them would give the other the gift of life by donating part of a major organ.

At age 30, Juanita had been suffering from liver disease -- triggered by chronic hepatitis -- for a decade. Her body's immune system was attacking her liver. By last summer, Juanita's condition had dramatically worsened. Her skin turned yellow. Her belly swelled so much, she joked that she almost looked pregnant. She endured grueling cramps in her legs, arms, and hands. And she had less and less energy, making it harder and harder just to get through the day.

Juanita needed a liver transplant. But with more than 18,000 other Americans on the waiting list, her chances of having the operation anytime soon seemed slim.

That's when Maria Elena made a heroic gesture. She volunteered to have a portion of her own liver surgically removed and transplanted into her older sister. So last November, the two women entered Cedars-Sinai Medical Center in Los Angeles and underwent the delicate, lifesaving procedure.

"Almost immediately after the surgery, even while tubes were still in me, I felt so much better," says Juanita. "When I was discharged 10 days later, I had to keep reminding myself that my surgical wounds still needed to heal. The rest of my body and mind wanted to do so much. I felt like doing cartwheels."

A Shortage of Organs

Living-donor liver transplants were unheard of before 1989, when a mother donated a portion of her liver to her child. Two years later, the first living adult-to-adult liver donation occurred. It was successful, but it didn't exactly start a tidal wave of similar procedures: In 1997, only three adult patients received a liver from a living donor.

By 1999, however, the numbers had begun to climb. In the first nine months of 2001, there were 365 living-donor liver transplants in the U.S. and 293 of those who received them were adults. While most liver transplants continue to use organs from bodies of people who've recently died -- nearly 3,500 of these cadaver transplants were performed between January and September 2001 -- the waiting list for liver transplants is growing at about 30% each year. The increasingly desperate need for organs is prompting many more surgeons to consider living-donor operations.

"If we had a sufficient supply of cadaver organs, we wouldn't want to subject a healthy donor to an operation of this magnitude," says Christopher Shackleton, MD, director of the multi-organ transplant program at Cedars-Sinai and a leader of the transplant team that performed the Chavez surgeries.

The success rate of living-donor procedures is 95% at Cedars-Sinai, and a bit lower nationwide. This is higher than the 85% success rate achieved with cadaver liver transplants at the same hospital.

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