Liver transplantation

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Honors presentation on Primary Schlerosing Cholangitis and Live Donor Liver Transplants

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Liver transplantation

  1. 1. Liver Transplantation: A Bond Regenerated Between Brothers Jessica McGuire Professor Cohen Anatomy and Physiology 16 February 2011 Johnson & Wales University
  2. 2. Donating Life <ul><li>James McGuire’s Insurance Application required the routine battery of blood tests </li></ul><ul><li>There were problems with James’ liver numbers </li></ul><ul><li>The application was declined and was immediately directed to go see a Doctor. </li></ul>
  3. 4. <ul><li>Perfectly Healthy Before </li></ul><ul><li>By October James’ health had declined at a rapid rate and was admitted to the hospital </li></ul><ul><li>His Doctor concluded that he in fact had Primary Schlerosing Cholangitis </li></ul>
  4. 5. Primary Schlerosing Cholangitis <ul><li>Primary Schlerosing Cholangitis (PSC) is a rare liver disease that typically affects Men in their 30-40s </li></ul><ul><li>Doctors still don’t know what cause it. </li></ul><ul><li>Average time between diagnosis and transplant: 9-10 years </li></ul>
  5. 6. Four Years <ul><li>In four years James had gone from feeling perfectly normal to having his name added to the cadaver waiting list. </li></ul><ul><li>In four years he had become very tired and fatigued </li></ul><ul><li>In four years his skin turned ‘yellow’ or “jaundiced” because his liver couldn’t get the bile out of his system. </li></ul>
  6. 7. <ul><li>Organs used for transplant typically come from cadavers </li></ul><ul><li>More than 96,000 people nationwide are waiting for an organ </li></ul><ul><li>More than 1,400 are in Arizona </li></ul><ul><li>Every 12 minutes a name is added to the national transplant waiting list </li></ul><ul><li>An average of 18 people die each day waiting for an organ.(UNOS) </li></ul>
  7. 8. A Second Option <ul><li>The liver is one of the few organs that can be transplanted from a living donor </li></ul><ul><li>The liver is made up of two parts, a right lobe and a left lobe </li></ul><ul><li>The right lobe is removed from the donor and transplanted into the recipient </li></ul><ul><li>The donor’s remaining left lobe regenerates itself in about 6 weeks </li></ul>
  8. 9. Testing Process <ul><li>As a family it was decided that a living donor would give James the best chance of survival, and a normal life. </li></ul><ul><li>Blood type, Cross match, Antibody screen, Urine Tests, X-Rays, Arteriogram, Psychiatric and Psychological Exams ( Wives are tested as well)(Mayo Clinic). </li></ul><ul><li>Final Blood Test and Cross Match (done within 48 hours of the surgery) </li></ul><ul><li>A friend volunteered and was eliminated due to vessel anatomy </li></ul><ul><li>Kelly (Sister) was eliminated due to lack of support system, and liver composition </li></ul><ul><li>Pernell was tested March, 2006 and was found to be a suitable match </li></ul><ul><li>. </li></ul>
  9. 11. McGuire siblings April, 16 th 2007 (night before transplant)
  10. 12. The McGuire Brothers Pre-Surgery.
  11. 13. “Just do it” <ul><li>April 17, 2007 Transplant day </li></ul><ul><li>Pernell went into surgery first, it took the Doctors five hours to remove the right lobe of the liver. </li></ul><ul><li>The liver is dissected at the falciform ligament </li></ul><ul><li>The surgery takes about 10-12 hours </li></ul><ul><li>The liver should be pink and fleshy, James’ liver was completely green from the bile and rock hard due to the scarring. </li></ul><ul><li>Due to the severity of James’ liver damage his entire liver was removed and replaced with part of Pernell’s </li></ul>
  12. 14. Diseased PSC Liver Healthy Liver Right Lobe Left Lobe Right Lobe Left Lobe
  13. 15. Complications <ul><li>Although Pernell had undergone the battery of testing, once he was open on the table it was discovered he had an extra bile ducts. </li></ul><ul><li>One week post surgery, he thought that he was feeling so bad due to the intensity of the operation, but bile was leaking into his abdomen </li></ul><ul><li>Dr. Mulligan’s first complication in 55 living donor transplant’s </li></ul><ul><li>Common complication in recipient, but not the donor </li></ul><ul><li>Stents were inserted and replaced four different times for drainage and his condition stabilized </li></ul>
  14. 16. Post – Transplant <ul><li>James’ long term prognosis is good </li></ul><ul><li>The success rate for a single organ transplant is 80%(UNOS) </li></ul><ul><li>The biggest obstacle is organ rejection, which James with continue to take medication to prevent </li></ul><ul><li>As long as he stays healthy this should not affect his typical lifespan. </li></ul>
  15. 17. James McGuire Pernell McGuire
  16. 18. Five Years Post-Transplant <ul><li>Pernell is currently the managing partner of McGuire Gardner PLLC. A law firm in Arizona </li></ul><ul><li>James is currently an Attorney for the firm helping to manage the Tempe, AZ office. </li></ul><ul><li>Both are wakeboarding enthusiasts, and can typically be found on a boat with their families </li></ul>

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