Creating Second Chances for All Ages: The Live Donor Liver Transplant Program

Jefferson surgeons recently performed their 5th adult live donor liver transplant, which allows a person to donate a portion of his or her healthy liver to a patient with advanced liver disease. The Jefferson Live Donor Liver Transplant (LDLT) Program is one of only three adult-to-adult live donor liver transplant centers in the Delaware Valley designated by the United Network for Organ Sharing (UNOS). A new cooperative arrangement with Nemours/Alfred I. DuPont Hospital for Children in Wilmington means that Jefferson patients of all ages can benefit from the region’s finest expertise with this procedure.

There have been strong ties between Jefferson and Nemours since the 1990s. Stephen Dunn, MD, FACS, Chief of Pediatric Solid Organ Transplantation at Nemours, explains that Nemours provides pediatric education for Jefferson medical students and serves as a clinical site for residents. Until last year, Dr. Dunn performed every pediatric solid-organ transplant himself. The newly formed team benefits from the expertise of four additional surgeons at Jefferson, led by Cataldo Doria, MD, PhD, FACS, the Nicoletti Family Professor of Transplant Surgery and Director of Transplantation and Warren Maley, MD, Director of the Live Donor Liver Transplant Program.

Every Jefferson donor candidate meets with the Independent Donor Advocate (IDA), Chief Medical Officer Geno Merli, MD, to discuss their motivations and the details and risks of the procedure. Nemours donor candidates undergo a similar process. The customary operation for live liver donation to small children in the U.S. removes 20 to 25 percent of the donor’s total liver volume. “This is well tolerated by the adult donors,” says Dr. Maley, “and it also makes what would be a full-size liver for a one-year-old child.”

The donor’s liver re-grows about 80 percent of the lost volume in the first week following the transplant and 90 percent after two weeks. About half of the liver transplants performed on children at Nemours involve live donors, which give child recipients the best chance for optimal outcomes.

“The first live donor liver transplant to a child recipient was in 1989,” says Dr. Maley, “and it remains the best way to provide a transplant to a child younger than two years old.” Nemours performs an average of 12 liver transplants each year. “It’s like the space program,” says Dr. Dunn. “We don’t have many launches, but each one is complex, challenging and specialized.”

For more information about Live Donor Liver Transplant Surgery visit: www.jeffersonhospital.org/LDLT