Liver-transplant surgeons use living donor.

Liver-transplant surgeons use living donor

A Chicago surgical team last week removed a left lobe of liver from 29-year-old Teresa Smith and transplanted the healthy tissue into her 21-month-old daughter Alyssa, who suffers from biliary atresia, an often fatal defect in the ducts carrying bile away from the liver. This is the first time U.S. surgeons have used a living donor for a liver transplant.

Pointing to studies showing that a partial liver will soon regrow lost tissue and begin functioning normally, the surgeons say the tissue donation should not pose significant long-term risk for Teresa Smith. At press time, both mother and daughter remained in stable condition.

Doctors plan to watch baby Alyssa for the first signs of tissue rejection. Using liver tissue donated by a genetic relative significantly lowers the risk of rejection, but Alyssa is receiving immunosuppressive drugs to further reduce that risk.

The transplant team faced an unforeseen complication when they accidentally damaged the mother's spleen during the operation and had to remove it to prevent profuse bleeding. The surgeons say they do not expect the loss of the spleen to have a significant impact on Teresa Smith's health, although it may increase her risk of infection.

Alyssa's transplant follows four live-donor liver transplants performed since November 1988 in Brazil, Australia and Japan. The use of living donors should improve the outlook for infants with fatal liver disease, says transplant team leader Christoph E. Broelsch of the University of Chicago. Surgeons can plan for such an operation rather than performing emergency surgery after a death makes a suitable organ available. In addition, doctors say the procedure could ease the shortage of cadaver livers. In the United States today, about half the infants awaiting liver transplants die before their physicians locate a suitable organ.