Family undergoes living liver transplant
By Eleni Berger
(CNN) -- Tuesday may be one of the longest days members of the Linthicum family have ever spent.
Mark Linthicum, 27, is donating part of his liver to his 55-year-old mother Dorothy, who is in need of a transplant.
"Anything for my mother," Mark Linthicum said. "That's the way I've always been. I told her I'd give her the whole thing if I had to."
Physicians estimate they will need 60 percent of the younger Linthicum's liver to place in his mother, whose bout with hepatitis C destroyed her liver. Living liver donors typically sacrifice half to three-quarters of their liver for the transplant.
"We take out her whole liver, her whole damaged liver, and then we put in a portion of his liver," explained Dr. Amy Lu of Georgetown University Hospital, where the procedure is being conducted. "And basically we figure out how much we need for her -- you need about 1 percent of a person's body mass in liver tissue for a liver to function properly and be able to regenerate."
The organ typically regenerates the missing portion in both donor and recipient within eight to 12 weeks, physicians say.
Liver transplants from living donors are a relatively new medical procedure. Although kidneys have been transplanted from living donors since 1954, the first living liver transplant didn't take place until 1989.
The operation is becoming more common, however, because the need for livers far outpaces the supply of organs donated from cadavers.
According to UNOS, the United Network for Organ Sharing, 18,190 people were waiting for liver transplants as of August 17. Last year, however, only 5,340 liver transplants were performed -- and, of those, just 347 came from living donors.
In 1990, 14 of the 2,882 liver transplants were living-donor transplants.
Screening for donors
Living-organ donation isn't the right choice for everyone, specialists caution.
Most donors are family members, though unrelated people such as spouses or close friends can also volunteer, as can complete strangers. Donors have to be in good health and undergo a battery of medical tests to ensure their organ is a good match for the recipient.
"I'm in very good health," Mark Linthicum said. "I consider myself a pretty tough guy. I've never had any major medical problems or anything."
Transplant centers also involve social workers in evaluating potential matches to be sure the donor is offering the organ for the right reasons. Donors who appear to be coerced or financially compensated are likely to be rejected. Occasionally, a psychiatric evaluation may be required before a donor is approved.
Surgery = risks
Then there's the actual surgery, which is not cheap. The procedure, which Medicare covers for qualified recipients, costs about $150,000, according to some estimates.
The risks for the donor are considered relatively low: The typical operation runs a 10 percent chance of complications and less than 1 percent chance of death, according to several leading transplant programs. Still, the donor is undergoing an invasive surgery, meaning potential problems exist.
Donors may lose blood and have to receive a transfusion, or may get an infection after they are cut open. Other organs near the liver might be damaged during the procedure. General anesthesia also poses risks.
For the recipient, of course, the risks are high. The liver may not function; infections may set in; the new organ may be rejected.
'She gave me life'
"I'm basically a strong person," said Dorothy Linthicum, a data entry specialist for the federal Nuclear Regulatory Commission. "I go in with that attitude, that everything is going to be all right."
However, receiving an organ from a living donor can bring some benefits. Because the surgery can be planned, the recipient can begin taking immune-suppressing drugs in advance, reducing the chances of rejection. If the donor is related, the tissue match is likely to be better, also reducing the chance of rejection.
For the Linthicum family, the benefits of the living transplant clearly outweighed the risks.
"It's very special," Dorothy Linthicum said. "He's giving me a chance to live longer. Apparently he wants to hold onto me a little longer."
Her son, an unemployed installer of lightning-suppression devices, agreed. "It wasn't a question, in my mind. Anything for Mom. She gave me life. I'm lucky enough to get a chance to give it back."
-- CNN's Saundra Young and Christy Feig contributed to this report.
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