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University Health Transplant Institute at University Hospital made history with the first-in-the-nation seven-pair living donor liver transplant exchange.
The medically and logistically complex process required matching seven remarkable people willing to donate portions of their livers with seven patients needing life-saving transplants.
Lead physician Tarunjeet Klair said the success of the exchange was a natural culmination of the work his team put into the program for both donors and patients.
“They need to trust us that we will perform their surgery, and then a week or a few days later, be able to transplant to the recipient," said Dr. Klair. "That trust is built by the work that we’ve done, the educational process that we have, and the informed consent process that we have," said Klair.
Dr. Klair confirmed that this particular chain was started by a non-directed donor — a person who donates to a random stranger. That person was 39-year-old Robert McDonald of Kansas City, Missouri.
McDonald said he did not think about organ donation as a thing he would ever do. "It just had never crossed my mind,” said McDonald.
That was until McDonald volunteered immediately as an understudy to help a loved one who needed a liver. His friend was eventually transplanted by a better biological fit, so McDonald made the altruistic decision to donate his liver to someone else in need.
“If it weren’t for my deep love and affection for the person that I was going to donate to, I really wouldn’t have thought about this. But I thought once that decision had already been made like, psychologically, I'd already decided I’m going to undergo surgery. I’m gonna donate my liver,” said McDonald.
McDonald was not aware of the extraordinary liver exchange chain he spurred until after the surgery. He drove to San Antonio from his home in Kansas City on the day of the event to meet his recipient Regina Toledo, and the other six patients for the first time.
Michael Cullen, MD, said a living-donor liver exchange of this magnitude is a very underutilized form of transplantation in the United States. Only about 6% of all liver transplants in the U.S. are from living donors. Cullen said the success of the operation is a testament to the team and very labor intensive.
For a donor hepatectomy, doctors remove the portion of the liver from the donor with an advanced surgical system using the da Vinci robot. Since its inception in 2000, the robot has undergone significant improvements like 3D visualization and technology to ease wrist movement during surgery.
Vidal Moreno is 71 years old and from Edinburg, Texas. His new liver came from relative April Burner. Moreno's daughter Marisol was the original donor, but her liver went to another recipient on the chain. Moreno’s family and friends were in the lobby with him for the day’s celebration.
“This thing is pretty awesome, you know. And a lot of people’s lives are saved. A lot of people are continuing their lives. I’m beginning to start a new career," said Moreno.
After serving for 22 years in the U.S. Army, Moreno is now applying to be an instructor with the Junior R.O.T.C. and said he feels better now than before the operation.
The seven-pair exchange was unprecedented in North America — until the life-changing procedures for Moreno, Toledo, and five others were performed at University Health in San Antonio.
