Experts urge caution with living liver transplants

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Experts urge caution with living liver transplants April 4, 2002 Posted: 3:34 PM EST (2034 GMT) -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- BOSTON (AP) -- Worried about the increasing number of partial-liver transplants from living donors, some doctors are proposing an external regulator be appointed to certify hospital units to do the surgery. The proposal, put forward Thursday in The New England Journal of Medicine, comes weeks after state health regulators sanctioned New York's Mount Sinai Hospital for "woefully inadequate post-surgical care" when a 57-year-old man died after donating 60 percent of his liver to his brother. In their proposal, James Trotter and three colleagues at Denver's University of Colorado said an external regulator should carry out the task of certifying such units. They also urged adoption of uniform medical criteria for picking donors and recipients. The number of living-donor liver transplants, which were first performed in the late 1980s, rose to 509 last year. About 97 percent of livers still come from dead donors. The survival rate of recipients is close to 90 percent for both procedures, the doctors said. Trotter and his colleagues said more live transplants could shorten waiting lists and offer medical advantages in some cases over the traditional practice of taking transplant livers from people who have just died. "Living-donor liver transplantation is a remarkably effective lifesaving procedure for selected patients," they wrote. But they warned that it may pose a greater risk of bile leaks for some recipients. In an accompanying article, Dr. Owen Surman, a psychiatrist who works with transplant patients at Boston's Massachusetts General Hospital, estimated the death rate for such donors at 1 percent -- far higher than for kidney donors. "It is still not clear exactly how safe it is to donate a large part of one's liver," he wrote. Donor Michael Hurewitz, a reporter for the Times Union, of Albany, N.Y., died January 13 at Mount Sinai three days after the surgery. The hospital was cited for 18 deficiencies -- including leaving a first-year surgical resident alone with 34 patients in the unit -- and barred from the living-donor surgery for six months. Copyright 2002 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.