Live Liver donation tragedy

The Boston Globe reports: At the Lahey, a stunning, rare tragedy--Donor dies in liver transplant attempt.

"A man who agreed to donate part of his liver to help a sick relative died while undergoing the transplant procedure at Lahey Clinic in Burlington two weeks ago, the hospital said yesterday.

"It was only the third death of an adult living liver donor in the United States in the two decades since the first procedure was done, according to two leading transplant surgeons. A total of 4,036 have been performed.

"While any surgery carries risks, specialists said the death of a living donor is especially upsetting because they are generally young and healthy and are undergoing an operation they do not need for the benefit of a family member or close friend."

..."“The safety of the donor is foremost in everyone’s mind,’’ said Dr. James Markmann, chief of transplant surgery at Massachusetts General Hospital. “It is a very safe operation, but the risk is not zero. If you do enough [of these operations], it will happen. Our thoughts go out to the donor’s family. They did a wonderful thing, and it’s tragic that it ended up this way.’’

"Markmann put the risk of death at one or two in 1,000 operations and said the risks to donors are like those for any type of major surgery, including infection, but generally are less because patients are healthy. He said these risks are weighed against the benefits to recipients: 10 to 15 percent of people waiting for a liver donation die each year because of a shortage of cadaver donors. About 1,500 liver transplant candidates died last year across the United States."

"Dr. Giuliano Testa, director of liver transplantation at the University of Chicago Medical Center, said there have been just three deaths of adult liver donors, the last in 2002 at Mount Sinai Medical Center in New York. He called the Lahey team one of the most “experienced and most expert’’ in the country."

..."Until 2001, the number of liver transplants from living donors in the United States had been growing, reaching a peak of 524 that year. Since then the number has declined, with 219 operations performed last year. Of those, 24 were done at Lahey.

"Surgeons said that the Mount Sinai death may have had a chilling effect on living liver donor transplants, but that in 2002 the cadaver liver allocation system was reorganized so that organs went to the sickest patients. This change reduced the need for living donors.

"Of the 323 living donor liver transplants done in Massachusetts since 1994, 215 were performed at Lahey. This is the first donor death since the program began in 1999, the hospital said."