First Liver Transplant Recipient, Now 11 Years Old, Received Transplant on Her First Birthday, in 1998
Major Milestone Celebrated With Donors, Recipients and Their Families
Dec 15, 2008
More than 1,000 patients have received lifesaving liver transplants at the Center for Liver Disease and Transplantation (CLDT) at NewYork-Presbyterian Hospital. The Hospital's first liver transplant patient, now 11 years old, was transplanted with an organ donated by her father on the day of her first birthday, Jan. 20, 1998.
Today the Hospital celebrated this milestone together with more than 200 liver transplant donors, recipients and their families. The event took place at the Malcolm X & Dr. Betty Shabazz Memorial and Educational Center in Manhattan.
"I want to congratulate the more than 1,000 patients who received liver transplants at NewYork-Presbyterian. It is a powerful testament to the success of our liver transplantation program that 10 years later, our first liver-transplant recipient has grown up and enjoys an active and healthful life," says Dr. Herbert Pardes, president and CEO of NewYork-Presbyterian Hospital. "This kind of success story is only possible in an academic medical center setting, where the experience and expertise of the nation's foremost specialists are focused on advancing new treatments to ensure the long-term health of patients."
Even though it treats some of the sickest patients, NewYork-Presbyterian's liver transplant outcomes are among the nation's best, with a five-year survival greater than 70 percent. The Hospital also offers transplants after a median wait time under 19 months, less than half that of other New York City area centers.
"This major milestone is the result of the tireless dedication of everyone on our liver transplant team — including hepatologists, surgeons, our transplant psychiatrist, diagnostic and pathology experts, advanced-practice nurses, social workers, coordinators and others," says Dr. Jean Emond, chief of transplantation at NewYork-Presbyterian Hospital/Columbia University Medical Center and the Thomas S. Zimmer Professor of Surgery at Columbia University College of Physicians and Surgeons. "Together we have come a long way in the last 10 years, pursuing innovations to increase access to transplantation and improve quality of life for patients with end-stage liver disease."
NewYork-Presbyterian Hospital's liver transplant program is among the top 10 centers in the country for number of transplants performed annually, with 122 performed in 2007, up from 46 in 1999, the program's first full year.
One important way of increasing the number of available organs has been living-donor transplantation, a technique pioneered by Dr. Emond that enables the patient to obtain a transplant right away, skipping the waitlist. It's a significant advantage since research first described at NewYork-Presbyterian shows that early transplantation with a living donor means a better chance at survival. Today, the Hospital is one of only a few programs to offer the approach and one of nine centers in the NIH-funded A2ALL consortium to study living donation. To date, the Hospital has transplanted more than 150 living-donor livers for both adults and children.
"A living donor can be a family member or friend," explains Dr. Emond. "In the procedure, a portion of the donor's liver is removed and implanted in the recipient. Both segments (the remaining section of the donor's liver, and the portion received by the patient) will regenerate and grow to fit the needs of each individual."
Another key innovation has been the Hospital's extended criteria donor (ECD) program, which uses advanced organ selection and preservation methods to make use of previously unused organs, such as those from older persons.
"With advanced techniques including improvements in anti-rejection medications, monitoring of organ rejection and organ preservation, we are able to use many more livers than we could 10 years ago," says Dr. Robert S. Brown Jr., director of the Center for Liver Disease and Transplantation at NewYork-Presbyterian Hospital, chief of the Division of Abdominal Organ Transplantation and the Frank Cardile Professor of Medicine and Pediatrics in Surgery at Columbia University College of Physicians and Surgeons. "The benefits are striking, with less than a quarter the number of waitlist deaths for ECD patients, compared to those on the regular waitlist."
Even more exciting innovations are on the horizon. "We are currently in the midst of a major initiative to expand our liver program," says Dr. Emond, citing new recruits including Dr. Tomoaki Kato, who adds expertise in multi-organ transplantation — procedures that replace as many as six organs — and a surgery called APOLT (auxiliary partial orthotopic liver transplantation) that resuscitates a failing liver by attaching a partial donor liver, making immunosuppressant drugs unnecessary.
The transplant initiative will also stress clinical research, says Dr. Emond. "Our patients have the opportunity to receive treatments available in only a few centers, or in no other centers." As one example, last year, NewYork-Presbyterian performed the first liver transplantation procedure in New York for a patient with bile duct cancer using an investigative technique that combines radiation and chemotherapy prior to surgery to improve outcomes, joining a select number of centers designing experimental approaches to treat this previously fatal disorder. Other ongoing research includes studies of specialized therapies for patients with hepatitis B and C, and blood-type-incompatible procedures.
Going forward, NewYork-Presbyterian will continue to give patients the kind of personalized care only possible through a multidisciplinary approach. "Our program stands out as one of the first built from its inception as a single unit, integrating medical, surgical and radiologic expertise," says Dr. Brown. "This means that the same team gets to know the patient and follows them from before transplant through to follow-up."
Liver disease describes any number of conditions affecting the liver, including hepatitis, cirrhosis, cancer and several hereditary diseases. Transplantation is offered to patients whose livers are no longer able to properly function, and will eventually shut down. At this time there are eight patients on the national waiting list for every available liver — and many patients are considered too sick or too old to be placed on the list. Among those with end-stage liver disease, more than 17,000 patients wait for a donated liver every year in the U.S., but fewer than 6,000 receive one, and about 1,800 people die while on the waiting list.
"In the coming years, we will continue to work toward improving these odds so every patient can enjoy long and productive lives," says Dr. Emond.
Transplantation at NewYork-Presbyterian Hospital
NewYork-Presbyterian Hospital's organ transplantation program — which includes NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center and the Rogosin Institute — performed more transplants in 2007 than any other center in the nation. It offers comprehensive and personalized care for the heart, liver, pancreas, kidney and lung. With outcomes ranked among the nation's best, the Hospital is dedicated to improving quality of life for its patients. NewYork-Presbyterian's dedicated teams of surgeons and physicians are responsible for many significant advances made over the past several decades in transplant surgery and the maintenance of healthy organs. The Hospital has been on the forefront of developing and improving anti-rejection medications (immunosuppressants), minimally invasive surgery for living donors, genetic methods to detect transplant rejection, strategies to increase opportunities for donor matching, islet cell transplantation, and the FDA-approved left ventricle assist device (LVAD), which functions as a bridge to transplantation for those waiting for a new heart.
NewYork-Presbyterian Hospital, based in New York City, is the nation's largest not-for-profit, non-sectarian hospital, with 2,242 beds. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including more than 230,000 visits to its emergency departments — more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Allen Pavilion and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health-care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. It ranks sixth in U.S.News & World Report's guide to "America's Best Hospitals," ranks first on New York magazine's "Best Hospitals" survey, has the greatest number of physicians listed in New York magazine's "Best Doctors" issue, and is included among Solucient's top 15 major teaching hospitals. The Hospital's mortality rates are among the lowest for heart attack and heart failure in the country, according to a 2007 U.S. Department of Health and Human Services (HHS) report card. The Hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.