Washington – The transplant surgeon had good news: A donated liver was on the way for critically ill Maggie Catherwood.
Then he asked: Would she let doctors cut off part of her new liver to share with an equally sick baby?
“I can’t imagine anyone saying no,” the 21-year-old college student said last week as, teary-eyed, she met 8-month- old Allison Brown, carefully cuddling the wide-eyed baby.
Actually, few ever get the choice – something the nation’s transplant network soon may change. There’s a push to increase liver-splitting that could have many more people who are awaiting transplants being asked to share a piece of their new organ.
If the proposed changes are enacted, “I think it’s safe to say we could nearly eliminate death on the pediatric liver waiting list,” said Allison’s surgeon, Dr. Thomas Fishbein of Georgetown University Hospital.
A liver is unlike any other organ: A piece of a healthy one can grow into a whole organ in about a month. That’s why some people receive liver transplants from living donors who have just a portion of their organ cut out and given away.
Split-liver donation is different. It divides an organ donated when someone dies, to try to save two lives.
It doesn’t happen often, accounting for between 2 percent and 3 percent of the more than 6,000 liver transplants annually. Just 123 split-liver transplants were performed in the U.S. last year, according to the United Network for Organ Sharing, which runs the transplant system.
“I didn’t even know it was possible” to split a liver, said Catherwood. But she said yes, and her first question upon waking up from surgery was, “How’s the baby?”
“The fact that someone else was willing to give up part of that liver they need is amazing to me,” said Terri Brown, Allison’s mother, in an emotional meeting with Catherwood.
Not every transplant center has the expertise or incentive to split livers, especially those that treat only adults. Nor can every donated liver be split.
But a rough estimate from the United Network for Organ Sharing is that more than 1,000 livers donated a year might qualify for splitting.
Fishbein is part of a network committee charged with spurring those transplants, in hopes of improving child survival.
Between 10 percent and 13 percent of young children on the liver waiting list die there.
