Saturday, March 06, 1999
Son gives mother half a liver
Transplant rare procedure between adults
BY TIM BONFIELD
The Cincinnati Enquirer
Carolyn Hines of Franklin, Ohio, calls it the best birthday present she's ever had.
Doctors at University Hospital call it a groundbreaking surgery that could help prevent many people who need a liver transplant from dying on the waiting list.
This week, Mrs. Hines, 55, became the first patient in Ohio — and one of very few worldwide — to receive a partial liver transplant from a living donor. Her 23-year-old son, Robert Hines, saved his mother's life by donating the bigger half of his own liver the day before his mother's birthday.
“To us, this demonstrates the tremendous commitment this son has made to his mother. It also illustrates the problems we face with the shortage of livers for transplant,” said Dr. Douglas Hanto, liver transplant surgeon at University Hospital.
Partial liver transplants from a parent to a child have been successfully done for several years, including several performed at Cincinnati's Children's Hospital Medical Center. But adult-to-adult partial liver transplants have been far less common.
The first one was performed in 1996 in Hong Kong, where cadaver transplants are not done. Since then, three other U.S. transplant centers (University of Colorado, University of Virginia and Mount Sinai Medical Center in New York) have performed about 30 similar transplants.
The limiting factor has been a reluctance to take away so much liver tissue from a living donor, which places two people at serious medical risk, Dr. Hanto said.
In children, transplant surgeons take part of the liver's left lobe (one-fourth to one-third of the liver's total mass). But for adults, the surgeons take the entire right lobe (which comprises more than 60 percent of the organ).
Doctors leave just enough liver in the donor to allow him to survive. Within three months, the partial livers in both patients grow expand to near-normal blood-cleansing capacity.
The double surgery, performed Monday, took about five hours for Robert Hines and about 12 hours for Mrs. Hines.
Mrs. Hines needed a partial liver transplant because she had no realistic chance of getting a cadaver organ through the national waiting list, Dr. Hanto said.
Mrs. Hines had a type of stomach cancer, diagnosed in 1990, that spread to her liver. Despite operations in 1993, 1994 and 1995 to remove diseased parts of her liver, the tumor was certain to destroy the organ — killing her within another year, maybe two.
Mrs. Hines had been on the waiting list for a donated organ for a year and a half. Yet she has never been sick enough to move up the priority list. Other patients with more acute liver disease continually leapfrogged her.
The harsh reality of waiting-list rules, which favor patients in immediate distress over slow-moving disease, is that by the time Mrs. Hines would be acutely ill enough to qualify, the cancer would have spread too far to justify doing the transplant, Dr. Hanto said.
Enter her son, Robert. Mr. Hines is single, works on the assembly line at General Motors, and is a part-time student at Miami University. He is the youngest of Mrs. Hines' three children.
His parents and his girlfriend were worried about him, but there wasn't much debate. The only obstacle was matching blood types and coming close in body size.
“It wasn't a very tough decision at all,” Mr. Hines said. “We only spoke about it for a couple of days, a week at most.”
Mother and son are doing well and are expected to be discharged early next week. Each will require about four to six weeks' recovery time.
While Mrs. Hines will have to take anti-rejection medications for the rest of her life, Mr. Hines can expect to return to normal activities with no restrictions, not even on alcohol.
“I feel very well,” Mrs. Hines said. “I feel so thankful and appreciative. I just love him more every day.”
Last year, eight patients died while waiting for liver transplants at University Hospital, and 38 died throughout Ohio, said Dr. Douglas Hanto, liver transplant surgeon at University Hospital.
University and Children's Hospital performed 62 liver transplants in 1998.
This year, University Hospital predicts it will do eight or nine partial liver transplants for adults.
“I suspect this will become more commonplace as we gain experience with it and as long as people are dying on the waiting list,” Dr. Hanto said.
True friends don't tolerate drunkenness
Fumes sicken 44 schoolchildren
Lack of calls angers parents
Poodle credited with alerting owner to fire
Fake hero story hits Vietnam vet just 'like a bullet'
Bad pacemakers cost firm $70 million
Pacemaker recipients will be monitored
Reforms may put disabled to work
Son gives mother half a liver
Swan sightings giving wings to pilot's prayer
Art museum director to resign at end of year
Bill could bring airport extra $6 million
Judge withdraws trip request
Volunteers renew search for Erica
Help for new moms pledged
Jazzy Jarreau takes journey with Pops
Larger study looks at Fernald
Polluters, communities dispute cleanup costs
Time Warner has new deal for Lebanon customers
Architect's career touched many schools
Area lakes stocking up for fishing season
City wins battle over fountains
Debate over jail site stalled
Diverse lesson in respect
Fairfield may erase school fees
Fixing pool gets a lot cheaper
Ft. Mitchell merger looks at finances
Merging three fire departments studied
TRISTATE DIGEST
Westwood hat's in, already
Yellow Cab buying site
