Advances in Liver Transplant Surgery

There've been a number of critical advances in liver transplant in the last two decades, but I think among the most profound is the development of living donor liver transplantation.

The liver is a relatively unique organ in the body in that it has a remarkable capacity for self-renewal and regeneration. Really, the only other organ like that is the skin. You could safely take up to 70% of someone's liver, and that remaining 30% will regenerate. The liver regenerates in both the donor and the recipient in about three weeks. It's quite remarkable.

In Preparation for surgery, following the battery of tests and medical interviews, the donor should strive to eat healthily, stay active, and the night before surgery, not have anything to eat or drink. The donor operation is about four hours from the time that we start the incision till the time where the dressing's on the patient.

I would expect them be as a post-operative hospitalization for roughly five to seven days, followed by weekly clinic appointments for two weeks. And then monthly for two months. I think for the donor, they probably reach what they would feel a full recovery in the three-month to four-month range.

For the recipients, I think this is a very invasive and aggressive procedure, but we're doing this so they have a normal life. So liver transplant is not a minor surgery. It's a major surgical intervention. And that's what I tell them when I meet them. And so we're going to make a very big step here, but this big step is to go back to doing the things that you want to do.

The recipient tends to stay in the hospital a little bit longer. A lot of times what determines the recipient's length of stay in the hospital is how ill and debilitated they are prior to the operation. But I would say the vast majority of patients are back to really living a normal life by about six months, if not before that.

What we tell the recipients is that the liver can be robust. And as long as you take your medicines and you have regular follow-up and get your labs drawn as we follow you for the rest of your life, we would expect you to get decades out of the liver transplant.

Being a small part of the transplant community that the surgeons serve is really being a part of something wonderful that one human in one family does for someone. But at the end of the day when you can see people do that for each other, it's nice to be part of that.