BOSTON-Domino liver transplantation, a procedure first performed four years ago in which a patient both receives a new liver and donates his old one, has debuted at two United States hospitals.
On January 1, New England's first domino transplant was performed at the Lahey Clinic in Burlington, Massachusetts. In the operation, a 28-year-old woman with amyloidosis, a fatal genetic liver disease, received a healthy liver from a brain-dead donor. The woman's liver, which was healthy except for its producing a single abnormal protein, "was implanted into an older, extremely sick patient who might have otherwise had little chance for a donor organ," the clinic said in a statement at www.lahey.org/Media/Releases/Domino.stm. It is thought that recipients of livers from patients with amyloidosis may take years to develop symptoms of the disease or may not develop them at all. Less than a week after the New Year's Day operation, Lahey Clinic surgeons performed a second domino liver transplant.
On December 4, the Philadelphia Inquirer reported that a domino liver transplant was performed at the Hospital of the University of Pennsylvania in Philadelphia on November 26. In that procedure, a young woman's liver was given to a 62-year-old man with familial amyloid polyneuropathy, and his liver was then given to a 58-year-old man who was believed to have about seven months left to live if he did not receive a new liver.
According to the Lahey Clinic, about 35 domino liver transplants have been performed around the world, only a few of which have taken place in the United States. On July 15, 1999, Transplant News Network reported on a domino liver transplant in Japan that involved four patients: the initial donor gave part of his liver to his brother, whose own liver was then split and given to two women.
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