Thursday, July 21, 2011

Liver Transplant Team Meeting Results

Today we met with the liver transplant team at Sick Kids, and learned the following.

1) The surgeon has no conditions on minimum age or weight.  As soon as a liver is available, either cadaver liver or living donor liver, he will do the surgery.  This was probably the most surprising piece of information for us, since we assumed there would be a minimum age/weight or both.  He said if we had a living donor ready the day baby was born, he would perform the surgery that day.

A living donor is someone (related or unrelated) who donates (via surgery) a part of their liver to be transplanted.  The donor's liver regenerates and grows back into a full liver...it's the only organ that will regenerate.  Pretty cool, eh?

2) Having a living donor for the day of the birth is nearly impossible because they do a maximum of a 15:1 weight ratio for donor to baby.  My previous two pregnancies have resulted in babies that were less than 6.5 lbs.  At 6.5 lbs for baby, the adult donor (18 years old or older) would have to weigh a maximum of 6.5 lbs * 15 = 98lbs!!

However, it is possible (but doubtful!) I would have a bigger baby, and also possible that baby will grow after birth.  With this in mind, here are some potential weights of baby vs weights of potential donor.

Baby weight  = Maximum Donor Weight
6.5 lbs = max donor weight of 98 lbs
8 lbs =    max donor weight of 120 lbs
10 lbs =  max donor weight of 150 lbs

3) Living donor would also have to match blood types with the baby. We know based on our own bloodtypes that the baby will either be B or O blood type.  The +/- part doesn't matter for liver transplant.  We will try to find out which one baby is before he is born.

If baby is O, then donor must be O blood type.
If baby is B, then donor can be either B or O blood type.

4) Sick Kids typically does 20-25 liver transplants each year, but this year the numbers have been much higher.  They are currently working on transplant number 22 for the year, and it is still July.  Approximately half of the transplants are via living donor, and the other half are from cadaver livers.

5) Approximately three transplants have been done over the last 2 years for urea cycle disorders (of which OTC is one of six), but all were for babies that were diagnosed after birth.

6)  This is the first time they have had a liver transplant in the planning stages before the baby is born.  Typically only heart transplants are prenatally known to be needed after birth.

7)  As soon as baby is born, he will go on the transplant list to receive a cadaver liver.  Wait times to receive a liver can never be guaranteed.  The hope is that baby can survive long enough to receive one using the medical treatment that the metabolic genetics team has come up with, as stated in my previous post The Treatment Plan (click here).

I'm sure I've probably missed some info in here.  If there is anything I missed that you would like to know, ask, and I'll answer!

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