Successful liver transplantation from a living donor to her son

Article Abstract:

Many children with advanced liver disease need a liver transplant, but it is difficult to find other infants and children able to donate a liver of the appropriate size. Therefore, many medical centers are now utilizing an alternate approach in which a portion of an adult liver is transplanted into a child; this is called reduced-size liver transplantation. The procedure was first performed using organs from cadavers, and the next step was to attempt transplantation from a living, related donor. Such a case is described; the donor was the 29-year-old mother of the recipient, her 17-month-old son. The boy was born with jaundice, a yellow tinge to the skin and eyes caused by elevated levels of bilirubin in the blood. The cause was obstruction of the flow of bile, a thick fluid produced by the liver and released into the small intestine to aid in digestion. During the time before his liver transplantation, the child underwent repeated surgical procedures, blood transfusions, treatment for recurring infections, and tube-feedings. After waiting six months for a donor, the family was encouraged to consider the option of a living related donor. The mother decided to be the donor, and the risks were carefully explained. The surgery was very successful for both mother and child, who are now healthy five months later. The donor was in the hospital for eight days, while her son required 40 days of recovery in the hospital. The risk to the mother was considered small, and the risk to the child was no greater than if the donated liver had been a reduced-size organ from a cadaver. Ethical issues are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Liver diseases, Ethical aspects, Liver, Liver transplantation, Donation of organs, tissues, etc., Tissue donation

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Experience with anencephalic infants as prospective organ donors

Article Abstract:

Recent advances have made organ transplantation in newborn infants possible, although such transplantation is limited by the scarcity of small organs available. Infants born without brains (anencephalic) can survive only a few weeks, and have therefore been considered potential organ donors. Legally, however, anencephalic infants can be used as organ donors only if their brain-stem activity has stopped. When anencephalic infants are treated in the usual way, their solid organs (as opposed to heart, lungs, bladders etc) undergo irreversible injuries due to lack of oxygen that make them unsuitable for transplantation by the time the infant is legally dead. Twelve anencephalic infants were treated in new ways to determine whether their organs could be preserved in usable condition for a week and whether brain death would still occur. Six received intensive care from birth, and six only when signs of imminent death appeared. Two infants became brain dead within a week, and no usable solid organs were obtained. Most organs had been suitable for transplantation when the infants were born. In the infants receiving intensive care from birth, organ function was maintained, but only one infant became brain- dead within a week. When intensive care only began when death was imminent, most organs were already too badly damaged to be usable. It was concluded that, under current law, it is usually not feasible to procure solid organs from anencephalic infants.

Organ donors, Tissue donors, Anencephaly

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Successful hand transplantation: one-year follow-up

Article Abstract:

One year after surgery, the 37-year-old recipient of a hand transplanted from a 58-year-old cadaver donor is able to feel pain, pressure, and temperature and he can write, turn pages, and tie his shoes. Immunosuppressive drugs successfully treated or prevented graft rejection.

United States, Statistical Data Included, Surgery, Organ transplant recipients, Hand, Immunosuppressive agents

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