Dec. 9, 1998 CHAPEL HILL - Friday the 13th turned out to be a lucky November day for Mrs. Mitsuko Brown, 67, of Hubert, N.C.
Her daughter, Barbra B. Howard of Asheville, and a team of University of North Carolina at Chapel Hill transplant surgeons made sure of that by providing her a healthy new liver to replace her own failing organ.
"Barbra gave me something that money can't buy, and that's my life," Brown said. "What she did and what the surgeons did was just overwhelming. Except for a sore throat, I feel good now for the first time in a long time."
At Howard's urging, UNC-CH School of Medicine physicians harvested part of the 44-year-old certified public accountant's liver and transplanted it into her mother, whose liver failed because of cancer and cirrhosis caused by hepatitis C. It was the first such operation in North Carolina and one of only a handful performed in the United States so far.
"Living-related adult-to-adult liver transplantation has just begun in this country in the past year, and that's very exciting," said Dr. Jeffrey H. Fair, assistant professor of surgery at UNC-CH.
"One of the chief reasons the new operation is so important is the shortage of organ donors," Fair said. "About 4,500 liver transplants from cadavers are done in this country each year, but that's nowhere near enough to help all the 11,000 people who are on the waiting list. About 15 percent of those people die each year because enough livers just aren't available, and the list grows by about 15 percent a year."
On the day of surgery, UNC-CH Drs. Mark Johnson and David Gerber removed right half, or lobe, of Howard's liver. Fair, chief of the abdominal transplant service, then grafted the lobe into her mother in a six-hour operation. Both mother and daughter said they are doing well.
Within about six weeks, Howard's liver will regrow to a size dictated by her body's needs, Fair said. It is the only organ that can do that. Likewise, within about the same span, Brown's new liver will grow to normal capacity.
Living adult-to-adult liver transplants have the potential of meeting up to a third of the national demand for such organs, the surgeon said. In that way, they will become comparable to living-related kidney transplants.
"This procedure affords the recipient a chance not to languish for years on the waiting list while getting sicker all the time," Fair said. "The donor organ is very healthy because it doesn't come from a cadaver, and it not only can be implanted immediately, it also is more likely to function well immediately.
"Surgeons can now act when recipients are at their best - before their liver disease produces serious infections or other complications that result in death or otherwise prevent the operation."
Some patients who need transplants such as cancer victims, but who cannot get on the waiting list because they are not yet in liver failure, also will benefit almost immediately, he said.
Despite pain during recovery, Howard said she would not think twice about giving her mother part of her liver again.
"When I learned of this new operation and told my mother about it, she was afraid for me and wasn't pleased that I wanted to take what she thought was a risk," Howard said. "To me, the small risk was nothing since I love her so much. We are very grateful to all the doctors and others who helped, and I'd do it again tomorrow."
The largest, the most complex - after the brain -- and one of the most important organs, the liver serves as a chemical factory for the body and regulates levels of most of the chief chemicals in blood, Fair said. Among the remarkably resilient organ's many functions are producing proteins for blood plasma, storing glucose the body doesn't need immediately and regulating blood levels of amino acids, the building blocks of proteins, he said. It also helps clear the body of drugs and poisons that would otherwise accumulate and excretes them in bile.
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