Innovative Surgery at Morgan Stanley Children's Hospital Helps Patient's Diseased Liver to Heal Itself, Making Lifelong Immunosuppressant Therapy Unnecessary
Apr 13, 2011
A 7-year-old boy with life-threatening acute liver failure is reportedly the first in the greater New York metro area to receive a partial-liver transplant. The innovative surgery, performed at Morgan Stanley Children's Hospital at NewYork-Presbyterian Hospital/Columbia University Medical Center on Nov. 26, is expected to help the boy's original liver heal, possibly eliminating the need for the lifelong immunosuppressant drug therapy required after a traditional liver transplant.
In the 12-hour technically demanding procedure, a section of the patient's diseased liver was removed and replaced with a portion of a donor liver. In the coming months, it is hoped that the donor organ will support the boy's liver function while his original diseased liver regenerates and heals. If the original liver has sufficiently regenerated, as predicted, the boy would then be taken off immunosuppressant drugs. As a result, it is expected that his immune system will naturally rid his body of the partial donor organ, which by then should no longer be needed.
The surgery was led by Dr. Tomoaki Kato, surgical director of liver and intestine transplant programs at NewYork-Presbyterian Hospital/Columbia University Medical Center and chief of abdominal organ transplantation and professor of surgery at Columbia University College of Physicians and Surgeons.
"The partial-liver approach works by making use of the liver's unique power to regenerate itself — something that is especially strong in children," says Dr. Kato, who has performed seven of such partial-liver procedures since 2005. "This process can take anywhere from two months to two years, but once it's complete the patient's original liver should be able to function normally."
The best candidates for partial liver transplants are children with acute liver failure, a condition where the liver abruptly stops functioning for unknown reasons. The approach doesn't work for chronic liver conditions that cause scarring, as scarring prevents liver regeneration.
The patient's medical care has been overseen by Dr. Steven Lobritto, medical director of pediatric liver transplantation at NewYork-Presbyterian/Morgan Stanley Children's Hospital and associate clinical professor of pediatrics and medicine at Columbia University College of Physicians and Surgeons.
"After recovery of his native liver, we plan to wean his immunosuppressant drugs off and expect that this boy will have a naturally strong immune system having survived acute liver failure without having to take daily immunosuppressant drugs for the rest of his life," says Dr. Lobritto.
For more information, patients may call 866-NYP-NEWS.
Special Note to the Media: NewYork-Presbyterian physicians and surgeons are available for interviews about the surgical procedure. At the parents' request, the patient is not available for media interviews.
Organ Transplantation at NewYork-Presbyterian Hospital
The organ transplantation program at NewYork-Presbyterian Hospital — which includes NewYork-Presbyterian Hospital/Weill Cornell, NewYork-Presbyterian Hospital/Columbia and The Rogosin Institute — is the most active program of its kind in the nation, offering 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) that functions as a bridge to transplantation for those waiting for a new heart.
NewYork-Presbyterian/Morgan Stanley Children's Hospital
NewYork-Presbyterian/Morgan Stanley Children's Hospital, located in New York City, offers the best available care in every area of pediatrics — including the most complex neonatal and critical care, and all areas of pediatric subspecialties — in a family-friendly and technologically advanced setting. Building a reputation for more than a century as one of the nation's premier children's hospitals, Morgan Stanley Children's Hospital is affiliated with the Department of Pediatrics at Columbia University College of Physicians and Surgeons, and is Manhattan's only hospital dedicated solely to the care of children and one of the largest providers of children's health services in the tri-state area with a long-standing commitment to its community. It is also a major international referral center, meeting the special needs of children from infancy through adolescence worldwide. NewYork-Presbyterian Hospital also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Westchester Division and NewYork-Presbyterian/The Allen Hospital. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report.