'Split-Liver Transplant' at UMC
Provides Life-Saving Organs for Baby, Adult

It's the first time UMC has performed a "split-liver transplantation," a logistically and technically challenging procedure in which one donated organ is transplanted into two patients. UMC operates the only pediatric liver transplant program in Arizona, New Mexico and Utah.

The life-saving surgeries were performed July 20-21 when Ernesto Molmenti, MD, PhD, MBA, chief of UMC's Abdominal Transplantation Program, and Hugo Villar, MD, chairman of the UA Department of Surgery, flew to an undisclosed Arizona hospital to evaluate and surgically retrieve the liver from a brain-dead donor. They painstakingly divided the organ, and then immediately returned to UMC with both liver pieces. As soon as they arrived, they transplanted approximately one-third of the liver into the baby, Maria Lara-Neri of Phoenix, and the remaining two-thirds into Rocky Steely of Sierra Vista. "It's a milestone for our Abdominal Transplant Program and for Arizonans with liver disease, especially young children," said UMC President Greg Pivirotto. Mr. Steely was released from the hospital on July 31 and baby Maria is expected to be discharged from UMC this week.

Dr. Ernesto Molmenti

"The little girl's situation before the transplant was very dire. She was essentially dying," Dr. Molmenti said. "Her condition was so grave that at times we had to remove her from the transplant list because it didn't look like she could survive the surgery. But she rallied, and this perfect liver came at just the right time."

Dr. Molmenti, who came to UMC in 2005 from Johns Hopkins and wrote a book on liver transplantation that includes split-liver procedures, was delighted with the surgery's outcome.

"Donated organs are so rare and so precious. There are so many people waiting for an organ. To see two people returned to health in a split-liver transplant doubles the gift of life. It's a privilege to do this work," he said.

Liver transplantation in babies and very young children is technically demanding because most donated organs come from adults and are simply too large for their small bodies, Dr. Villar explained. They often have to be pared down, wasting most of the organ. The liver, which removes waste material from the body, is one of the few organs in the body that regenerates itself. The liver segments in split-liver transplantation are expected to grow to normal size in both patients. Dr. Molmenti said the split-liver transplant and follow-up care involved a large team of UA medical specialists, including hepatologist Thomas S. Boyer, MD, of the Liver Research Institute; liver transplant coordinator Lu Maselli, RN; anesthesiologist Scott Polson, MD; gastroenterologists Fayez Ghishan, MD, and Hassan Hassan, MD; the pediatric intensivist team led by Andy Theodorou, MD; UMC critical care nurses, and pediatric intern Christine Graham, MD, who received a liver transplant when she was 4 years old and was a strong advocate for getting the baby on the transplant wait list even when her chances of survival appeared remote. # # # Media opportunity: To interview Dr. Molmenti and photograph baby Maria before her release from UMC, call the AHSC Office of Public Affairs, (520) 626-4828. The child's parents do not wish to be interviewed. B-roll of the transplant surgeries is available.