liver

Stamford CT woman gives husband the gift of life

by Columbia Surgery on January 17, 2012

When Brad Shwidock needed a liver transplant due to primary sclerosing cholangitis, his wife, Carol, was not only eager to donate, but was a good match. The successful living donor transplantation took place at NewYork-Presbyterian/Columbia September 13, 2011.

Living donor liver transplantation is considered one of the most important advances in the treatment of severe liver disease. By improving access to transplantation, living donor transplantation significantly reduces patients’ risk of dying while on the organ donation waitlist. At the Living Donor Liver Transplant program at New York Presbyterian Hospital, which is one of the largest living donor liver programs in North America, approximately 15-20% of the center’s transplant patients currently receive a liver from a living donor.

Read the Shwidock’s story as reported by the couple’s local paper, The Hour Online.
Learn more about living donor liver transplantation at livermd.org or by calling 1.877.LIVERMD (1.877.548.3763).

Tagged as: liver, sclerosing cholangitis, transplant

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Challenges in Liver Transplantation: Allocation of Donor Organs

by Columbia Surgery on November 16, 2011

Robert S. Brown, Jr., MD, MPH

Robert S. Brown, Jr., MD, MPH

The November 10, 2011 issue of the New England Journal of Medicine features an editorial by Robert S. Brown, Jr., MD, MPH, Director of the Center for Liver Disease and Transplantation, titled Transplantation for Alcoholic Hepatitis — Time to Rethink the 6-Month “Rule.”

In this editorial, Dr. Brown addresses the difficult questions surrounding how to fairly allocate donor organs, which are in far shorter supply than their demand. In the case of patients with alcoholic hepatitis, current guidelines exclude such patients from the liver transplant waiting list unless they have successfully abstained from alcohol for at least six months. Yet as Dr. Brown points out, many die before this required, albeit arbitrary, window elapses. And a new study indicates that if they are permitted to receive liver transplants, such patients may do at least as as well as, if not better than, some other patients who receive transplants far more often.

As Dr. Brown explains in this editorial, the typical recidivism rate among alcoholics is approximately 30%. Yet organs are regularly allocated to patients with hepatitis C, who have a 100% disease recurrence rate, and a much higher rate of graft failure than those with alcoholic hepatitis, at five years. A study by Mathurin et al in this issue found that carefully selected patients with alcoholic hepatitis experienced a 77% survival rate after liver transplantation at six months, and a recidivism rate of 11.5%. Based on these encouraging results, Dr. Brown writes, “…this study highlights the need to rethink our approach to transplantation for alcoholic liver disease, including applying better rules for selecting patients who are at low risk for recidivism that can be applied in a uniform and fair way.”

Tagged as: Brown, hepatitis, liver, transplant

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All in the Family: Woman Donates Left Lobe of Liver to Her Fiancé

by Columbia Surgery on November 9, 2011

When Megan Ellerd and Steven Ferretti met seven years ago, it was “instant love,” she says. Not long after, the young couple found out that Steven had autoimmune hepatitis — but they didn’t worry too much about it, hoping that it wouldn’t affect them until much later in life. In 2008, however, the two were happily engaged when Steven’s condition suddenly took a turn for the worse. His liver was failing, and he needed a transplant.

Although Steven had severe liver disease and was experiencing painful symptoms such as ascites (fluid buildup in the abdomen), he would have had to become deathly ill in order to qualify for a donor organ from the transplant waiting list. For a couple with a wedding to plan and a bright future ahead, the prospect of Steven spending many months, if not years, in progressively worsening health was just not an option. For Megan, the choice was clear. She had known from the beginning that she would donate part of her liver to him if she could — and when testing confirmed she was a good match, that’s exactly what she did.

Megan Ellerd and Steven Ferretti

Steven Ferretti and Megan Ellerd

On January 6, 2011, the team at the NewYork-Presbyterian/Columbia Liver Transplant Program transplanted Megan’s left lobe to Steven, an operation that not only saved his life, but spared him the ordeal of becoming even sicker while waiting for a liver from the organ donor waitlist. Benjamin Samstein, MD, Surgical Director of the Liver Transplant Program, and Lorna Dove, MD, MPH, Medical Director of Adult Liver Transplantation, are happy to report that the transplantation was a success, and that Steven and Megan have both made excellent recoveries.

Both Steven and Megan have been transformed by the experience; they speak of their gratitude for the support they received from their loving families, and of a newfound appreciation for life. Thanks to the team at Columbia, and to each other, they’re now thinking of having kids and possibly starting a new business. Whatever they decide, they’re fortunate to be able to do it in good health, and together.

Tagged as: hepatitis, liver, Samstein, transplant

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Advances in Liver Transplantation: Abstracts presented at the American Transplant Congress in May, 2011

by Columbia Surgery on June 2, 2011

American Transplant Congress

American Transplant Congress

Each year, the nation’s leading transplant surgeons convene at the American Transplant Congress, a joint meeting of the American Society of Transplant Surgeons (ASTS) and the American Society of Transplantation (AST). Surgeons from NewYork-Presbyterian Hospital/Columbia University Medical Center presented the results of their latest research, including the following.

Presentation 1: Excellent Outcomes of Machine Preservation of “Orphan” Extended Criteria Liver Allografts: Interim Results of a Phase 2 Trial;.

James V. Guarrera, Benjamin Samstein, Scot D. Henry, Claudia Musat, Charlotte Fisher, Theresa Lukose, Tomoaki Kato, Jean C. Emond. Division of Abdominal Organ Transplantation.

Between the time a liver is retrieved from a donor and transplanted into the recipient, it must be very carefully preserved in order to maintain optimal function. An approach known as cold storage (CS), essentially keeping the organ on ice during transport, has been the standard practice in liver transplant for 20 years. Now there is new evidence that a technique called hypothermic machine perfusion (HMP) outperforms standard preservation, according to the first-ever study comparing the impact of the two techniques on transplant outcomes. The phase I study was carried out by Dr. James Guarrera and his colleagues at NewYork-Presbyterian Hospital/Columbia University Medical Center.

Unlike cold storage, which Dr. Guarrera describes as a static technique, HMP dynamically simulates “aliveness” by providing a continuous flow of oxygen and key nutrients to the liver while diluting and removing toxins and waste products. In his presentation to the American Transplant Congress in May 2011, Dr. Guarrera reported that HMP reduced injury to donor organs effectively enough that organs declined elsewhere for transplantation could be preserved well enough to function successfully after transplantation. Of 15 ‘extended criteria’ livers preserved using HMP in this study, all had good function after transplantation. Fourteen patients were alive and well at the time of presentation, and one patient had died due to multidrug resistant Klebsiella sepsis.

Watch for ATS Presentations 2 and 3 later this month at columbiasurgery.net.

Tagged as: Emond, Guarrera, Kato, liver, Samstein, transplant

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One Death Provides New Life for Many

by Columbia Surgery on May 26, 2011

New York Times article highlights transplant donor and recipients at New York-Presbyterian Hospital

Organ Donation Checkbox

UK NHS Organ Donation Checkbox

As organ transplantation has advanced and improved in recent decades, more and more patients’ lives are saved every year. But the most pressing problem in organ transplantation has yet to be solved: the shortage of donor organs available to the thousands of people waiting on lists for a new kidney, liver, lung, heart, or other organ. People who intend to donate may not indicate their wishes to family members before their death, or families are reluctant to make that decision in the midst of profound grief and loss. For others, donating an organ was just never something they knew much about or even considered.

When they do choose to donate a loved one’s organs, families usually remain anonymous, as do those whose lives they save. Perhaps that is why articles like the one in the New York Times on May 16, 2011, touch and inspire readers so deeply. This version of an increasingly common story captures the essential soul-searching, as well as the profound gratitude, hope, and solace, that marked the meeting of Mirtala Garcia and the people who received her husband’s organs.

After his sudden death by a brain hemorrhage, transplant surgeons at NewYork-Presbyterian Hospital transplanted Julio Garcia’s heart, both kidneys, pancreas, liver (divided to save one adult and one child), one lung, and his corneas — saving seven lives and restoring sight to another.

Read the full story: One Death Provides New Life for Many.

NewYork-Presbyterian Hospital/Columbia University Medical Center is one of the nation’s foremost centers for transplantation of the heart, lung, kidney, pancreas, liver, and abdominal organs. For information, visit www.columbiasurgery.org and see Surgical Specialties.

Tagged as: cardiac, liver, lung, transplant

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Health and Education for Asian Livers (H+EAL)

by Columbia Surgery on May 4, 2011

NYP/Columbia and NYP/Weill Cornell Outreach Program Educates New York Immigrants about Hepatitis B

Hepatitis B is one of the world’s most serious healthcare issues. This chronic infection can cause cirrhosis of the liver and liver cancer. Common in Asia, eastern Europe, Africa, and the Caribbean, hepatitis B infection is most prevalent in Asia. With a large immigrant population from Asia now residing in the U.S., hepatitis B has become a significant health issue in the U.S. as well. At this time, over 10% of New York City’s population is Asian.

When treated properly, the prognosis of people with chronic hepatitis B is generally good. Even patients who develop cirrhosis or liver cancer along with hepatitis B can expect to fare well in the long-term when the infection is detected and treated early. However, if the disease is diagnosed too late or left untreated, patients may die at a young age. The Center for Liver Disease and Transplantation (CLDT) treats many people with chronic hepatitis B infection, some of whom were previously unaware they had hepatitis B or who had been misinformed by other healthcare providers about the disease.

Prevalence of chronic infection with hepatitis B virus, 2006 (CDC)

Prevalence of chronic infection with hepatitis B virus, 2006. (CDC)

To raise awareness about hepatitis B and encourage Asian immigrants to seek treatment, liver surgeons at CLDT are conducting outreach events with high school students as part of a program called Health and Education for Asian Livers, or H+EAL. According to Tomoaki Kato, MD, Chief, Division of Abdominal Organ Transplant, and Surgical Director, Liver and Gastrointestinal Transplantation, who initiated the outreach effort, “Because of language and cultural barriers, it is very difficult to reach first-generation immigrants to teach them about health issues such as hepatitis B. But their children tend to be well-educated and, of course, fluent in English. We believe that targeting the offspring generation is the best way to reach the first generation immigrant. If high school students are told they can be a life-saver for their family, they will tell their family about it.”

Together with medical students at NewYork-Presbyterian Hospital, Dr. Kato has developed educational presentations and has spoken at Hunter College High School, Bronx Science High School, and others in the New York metropolitan area. Other leaders of the outreach program include Arlene Loh, patient advocate, and Maya Gambarin, MD, hepatologist at NewYork-Presbyterian/Weill Cornell.

For information about hepatitis B and the CLDT, please visit livermd.org.

Tagged as: hepatitisb, Kato, liver

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My Life as a Second Time Liver Transplant Recipient: Patient Voices

by Columbia Surgery on April 29, 2011

Hello pre‐ and post‐liver transplant patients. I am a 24 year old mother of a beautiful, healthy three year old boy. I am also a post‐liver transplant recipient, not only for the first time, but for the second.

I was born with a condition called biliary atresia and the doctors said I would never make it to the age of seven but I fought. I fought for my life until I reached the age of fifteen which is when I received my first liver transplant. It was quite an experience to remember. Actually having a liver transplant is an experience you will never forget.

My recovery was fairly painful and interesting too. It was tiring because I had to juggle school (I had home schooling), my clinic visits (which were every week at first then every two weeks depending on my blood work and so on). Everything with my liver transplant was going well. I even had a baby in 2006.

However, my first liver transplant would not last long for me because of my neglect and improper care of myself to maintain my health and the health of my liver.

So in the year of 2007, I began to become very sick due to rejection. My eyes turned yellow, my nails turned yellow and my hair started to fall out. I also began to accumulate so much water in my body that eventually down the line I was no longer able to fit into my sneakers or any shoes for that matter.

In 2010, I was so ill‐struck, that I was literally knocking at death’s door. I cried and cried and worried myself so about dying that I fell into a deep, dark depression. I didn’t do my hair, I wouldn’t talk to anyone, I wouldn’t go outside, I wouldn’t even acknowledge my son. I became totally isolated but through all that I still managed to pray to God and keep my hope as well as my faith in him. Then on June 25, 2010, all of my worries would be set aside and I would be thanking God so much for saving my life. On this day, I received the gift of life once again. Recovery, though, would be much more difficult to get through not only because it was my second transplant but because I ran into a couple bumps in the road. But, through God and my doctors, I would get through my bumps and be on my way home to be with my family as a new person who they can love and respect once more.

So I say to all transplant and non-transplant patients, always take care of your new organ and yourself. Also always keep in mind whenever you feel like you want to give up that somebody’s loved one had to lose their life to help save yours.

Tagged as: biliaryatresia, liver, transplant

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Tomoaki Kato Leads Abdominal Organ Transplantation at NewYork-Presbyterian/Columbia

by Columbia Surgery on April 28, 2011

Tomoaki Kato, MD

Tomoaki Kato, MD

NewYork-Presbyterian Hospital/Columbia University Medical Center has appointed Tomoaki Kato, MD, Professor of Surgery, as Chief of the Division of Abdominal Organ Transplantation. Dr. Kato is a renowned expert in liver and intestinal transplantation and complex abdominal surgeries in adults and children.

In addition to the liver transplant program. Dr. Kato leads NewYork-Presbyterian/Columbia’s new program for small bowel and multivisceral transplantation. These rarely performed procedures are reserved for patients with complex abdominal pathologies – primarily short gut syndrome and intestinal dysmotility in children, and mesenteric thrombosis and trauma in adults. The intestinal/multivisceral transplantation team includes highly experienced surgeons and a gastroenterologist, nurse practitioner, social worker, psychiatrist, and nutritionist who guide patients through a lengthy and challenging recovery.

In some cases, surgeons perform ex vivo resection, operating on an organ removed from the patient’s body and then returning it to the patient. This was the approach that Dr. Kato and a team of NewYork-Presbyterian/Columbia surgeons used to resect 15 pounds of liposarcoma entangling surrounding organs of a 59-year-old man during a highly publicized 43-hour operation in December 2009.

They also performed another well-publicized case in February 2009 in a seven-year-old girl, using an ex vivo approach to take out entire abdominal organs temporarily and remove a deep tumor entangling major blood vessels of the viscera. Ex vivo resections may be applied to various tumors that are unresectable using conventional approaches, including liver and pancreatic tumors and sarcomas.

Since joining NewYork-Presbyterian Hospital/Columbia in August 2008, Dr Kato has been leading the institution’s liver transplant program, using both deceased and living donor livers. The center has generated some of the strongest outcomes data in the world. “We have a long history of transplanting high-risk patients effectively with good outcomes,” said Dr. Kato

Related Link:
New York State Liver Transplant Outcomes

Tagged as: Kato, liver, transplant

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Join Team Gratitude in Fighting Liver Disease: Walk in the American Liver Foundation Liver Life Walk on June 5

by Columbia Surgery on April 26, 2011

Team Gratitude at the 2010 NYC Liver Life Walk

Team Gratitude at the 2010 NYC Liver Life Walk

Are you, a family member, or a friend affected by liver disease? Help make a difference by walking with NewYork-Presbyterian’s Team Gratitude this spring.

The annual American Liver Foundation NYC Liver Life Walk will be held Sunday, June 5, 2011 in Battery Park, NY.

Team Gratitude includes patients with liver disease, liver transplant donors and recipients, friends, family members, physicians, and others connected through NewYork-Presbyterian Hospital Center for Liver Disease & Transplantation. Celebrating its tenth year, the team is united in its commitment to fight liver disease. As part of that commitment, members walk for many reasons: to raise awareness about liver disease, to improve prevention of liver disease by raising funds for the American Liver Foundation; to walk in memory of a loved one; to represent the 30 million Americans fighting liver disease today; and to walk in gratitude towards life.

To join Team Gratitude at the NYC Walk, go to the Team Gratitude team web page. Scroll down the page to see the list of team members, and select the “Join Team” link (at the top of the list of team members). Then, follow the instructions to register for the ALF Liver Life Walk as a part of Team Gratitude.

If you would like to support Team Gratitude in other towns, a few of the members will be participating in these ALF walks:

  • May 22, 2011: Eisenhower Park, NY.
  • June 12, 2011: Verona Park, NJ.

For information about Team Gratitude, contact Jessica Chipkin, at jessica.chipkin@gmail.com

For information about the American Liver Foundation and/or the Liver Life Walk, please contact ALF’s Event Manager, Dilber Koyuncu, at dkoyuncu@liverfoundation.org
or (212) 943-1059.

Tagged as: liver

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Center for Liver Disease and Transplantation Named Top Center for Hepatitis B

by Columbia Surgery on April 8, 2011

Newsmax online magazine listed NewYork-Presbyterian Hospital/Columbia University Medical Center as one of the top ten treatment centers in the U.S. for hepatitis B. In its review, Newsmax said “The hospital has remarkable statistics on curing patients with hepatitis B. The Center for Liver Disease and Transplantation at the center is one of the best of its kind in the U.S.”

Electron micrograph of Hepatitis B virus

Electron micrograph of Hepatitis B virus

Hepatitis B is a liver disease caused by the hepatitis B virus. The Center for Liver Disease and Transplantation at NewYork-Presbyterian/Columbia is a multidisciplinary program that treats all forms of liver disease including hepatitis B and C, liver cancer, and more.

Related Link:
Newsmax.com Hepatitis B: Top 10 Treatment Centers

Tagged as: hepatitisb, liver

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