Recently, a rare half-liver transplant was successfully performed on 2-year-old Brenner Logan in Holtz Children's Hospital at University of Miami/Jackson Memorial Hospital. This is the same hospital where now 6-year-old Alexander Mongene underwent the same procedure 2 years ago.
In the operations, both boys were given only half a new liver. Half of their old liver was cut out, leaving the other half intact. The purpose of the new half liver, protected by anti-rejection drugs, is to take over the old liver's function, easing the old liver's load so it can regenerate. If the old liver grows back to its normal size, the anti-rejection drugs-which can have significant side effects-can be discontinued. Without these drugs, the new, transplanted half-liver will then wither away.
The half-liver transplant is new and somewhat controversial, experts say.
"I'd say it's rare, with about 30 operations performed in Europe and only a handful in the United States," said McGowan Institute faculty member Dr. George Mazariegos, director of pediatric transplantation at Children's Hospital at the University of Pittsburgh Medical Center, a leader in the field. The hospital has done one such procedure.
"There was initial enthusiasm in Europe, but then longer-term follow-up showed a higher rate of retransplantation than with full-liver transplants," he said. In Europe, doctors were urged to select candidates carefully for the surgery.
"You want a patient whose liver has a good chance of regeneration," said Mazariegos. "I'd say this is a good contribution, but the standard of care is still full-liver transplantation."
Children's Hospital of Pittsburgh has performed more than 1,000 pediatric liver transplants in children to date, making Children's the most active pediatric liver transplant center in the country.
Illustration: McGowan Institute for Regenerative Medicine.
Miami Herald (08/15/07)
Children's Hospital of Pittsburgh/Pediatric Liver and Intestine Transplantation