Aliana Deveza of Santa Cruz, California decided to “swap” half of her own liver for someone else’s kidney. It was the only way to help her mother with kidney failure. The operation (four in fact, which were performed on the same day) was performed by surgeons from the University of California, San Francisco. It was the first such procedure in the world. The case was described in the American Journal of Transplantation.
Erosalyn Deveza, mother of Aliana Deveza from Santa Cruz (California, USA) suffered from kidney failure and needed constant dialysis. Her daughter was ready to donate her own kidney, but doctors advised against it – she will probably need a transplant as she gets older. Therefore, Aliana decided to help in a different way. In 2017, she initiated the world’s first exchange of various organs between living donors, replacing half of her own liver with another person’s kidney. A case study has just been published and the University of California San Francisco surgeons involved are calling for more such exchanges.
Most organ transplants come from the deceased, but there are never enough organs for those who need them. Since most people can only live with one with a kidney, people with kidney failure are increasingly getting organs from relatives or friends.
If someone wants to donate a kidney, but it does not match the recipient’s immune system, doctors can find pairs of would-be donors, each of which can donate the kidney to a relative of the other. Sometimes long transfer chains form.
While investigating the subject, Aliana Deveza came across a work describing the idea of ”barter” of kidneys for the liver, the only other organ usually collected from a living donor. People can donate up to 60 percent. liver because it is able to regenerate. After part of the liver is transplanted, both the donor and recipient have a full-sized organ.
For the hospitals to which Alian applied, the idea was too avant-garde – the doctors did not even know who to refer her to. Eventually, she contacted John Roberts of the University of California, San Francisco. He concluded that the idea had potential and that the woman was healthy enough to donate part of the liver.
After 1,5 years, we found a patient whose liver was unsuitable for transplantation to a seriously ill sister (Annie Simmons from Boise, Idaho). The plan whereby Simmons would donate the kidney to Deveza’s mother and Deveza’s half of the liver to Sister Simmons was approved by the ethics committee.
Theoretically, the fairness of the exchange could be questionable. You can survive with kidney failure for many years thanks to dialysis, while a failing liver cannot be replaced. Moreover, complications occur more frequently in liver donors. However, the originator did not hesitate.
Four operations were performed on the same day. For several weeks, the liver donor felt very tired, which was due to the involvement of the organism in the regeneration of the liver. But after two months, an ultrasound showed a similar picture of the liver to normal.
The surgeons who performed the operation hope to inspire more people. If up to 30 additional living donor liver transplants per year are performed in the United States, that would be 10 percent. increase.
Author: Paweł Wernicki