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TIME: Almanac 1990
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1990 Time Magazine Compact Almanac, The (1991)(Time).iso
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121189
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12118900.067
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1990-09-22
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HEALTH, Page 96A Mother's Gift of LifeHer baby gets the first U.S. liver transplant from a living donor
Like some 150 other young children in the U.S., 21-month-old
Alyssa Smith was waiting for a new liver, her one chance to avoid
death at an early age. Her prospects did not look bright, since
the supply of livers taken from cadavers and suitable for
transplant is critically slim. But last week a team of surgeons at
the University of Chicago Medical Center gave the little girl from
Schertz, Texas, her chance to live. And what seemed truly
miraculous about the operation was the source of Alyssa's new
liver: her mother.
In a 14-hour procedure, the surgeons removed the fist-size left
lobe from 29-year-old Teresa Smith's liver and transplanted most
of it into her daughter. The revolutionary technique --
transplanting a liver from a living donor -- had been performed in
Brazil, Australia and Japan, but this was the first time it was
tried in the U.S. Doctors have had a great deal of success in
kidney, pancreas and bone-marrow transplants from living donors,
and hope is rising that the liver will join that list. Says Dr.
Christoph Broelsch, who led the Chicago transplant team: "This
surgery potentially opens up a whole new pool of donor organs for
infants. It's the first step in answering the problem of juvenile
organ shortage."
So far, both mother and daughter are doing well. Because the
liver has the power to regenerate itself by forming new tissue,
Teresa's liver should grow back to its normal size. Similarly, baby
Alyssa's new liver should grow as she does.
The operation was not without serious complications. While the
surgeons were removing part of Teresa's liver, they tore her spleen
and decided they had to remove it. The loss of the spleen means
she will be slightly more susceptible to infections, and may have
to take antibiotics for the rest of her life. To gain access to the
liver, the doctors also had to remove Teresa's gall bladder. As
for the baby, she had to undergo a second operation to stop
bleeding from her new liver. The doctors hope Teresa can be
released from the hospital this week and that her daughter will be
home for Christmas.
The dangers inherent in such complex transplants pose ethical
dilemmas for the medical community. University of Chicago ethicists
and physicians spent a year discussing whether doctors have the
right to ask healthy parents to donate portions of their vital
organs, even if it means saving the life of their child. Critics
argue that there is no way parents can refuse such a request when
under the pressure of having a dying child. For that reason,
university officials required a two-week delay between the time
Teresa and her husband John signed the consent forms and the date
of the transplant, so that the family could reconsider the
decision. "It was purely voluntary," says Dr. Peter Whitington, a
pediatric hepatologist on the transplant team. "I think this
mother, even if she had greater complications, would believe she
did the right thing. I believe this father, even if he lost his
wife, would believe he did the right thing."
Some families may not want to have two members undergo major
surgery at once. But for the Smiths, the risk was well worth the
possible returns. Says Teresa: "Once you've given someone a big
piece of your heart, it's easy to throw in a little bit of liver."