NY Warns Liver Transplant Centers to Use "Extreme Care"

The warning came as Health Commissioner Antonia Novello outlined problems in post-surgical care at Mount Sinai Hospital, where a 57-year-old man died Jan. 13 after donating 60 percent of his liver to his ailing brother (see story)..

More living-donor adult-to-adult liver transplants are performed in New York than any other state. In the year ending June 30, 2001, about one third of all living-donor adult liver transplants performed in the U.S.took place at four New York hospitals.

Mount Sinai performed 52, the University of Rochester Medical Center performed 49, New York University Medical Center performed 20, and Columbia-Presbyterian performed 13.

The technically demanding surgery, which poses a risk of mortality variously estimated at .5 percent to 1 percent to an otherwise healthy donor who undergoes the operation solely for the purpose of helping someone else, has been the subject of considerable debate within the surgical and bioethics communities.

While the death of Mike Hurwitz was only the second documented death among adult-to-adult liver donors in the United States, several have occurred in Europe, and surgeons widely believe other deaths in this country have gone unreported. Hospitals are not required to report their results except for unnatural deaths, which must be reported to the state.

But beyond the risk of morality, serious complications for the donor following the living liver transplant surgery are not uncommon.

Dr. Jay Hoofnagle, director of the division of digestive diseases and nutrition at the National Institutes of Health, said more information exists about people who receive cadaveric organs than about those who undergo live donor operations, because hospitals must provide information on cadaver transplants to the United Network for Organ Sharing.