Breakthrough in Liver Transplantation…Small Liver Grows Inside Patient’s Body

A pioneering surgery performed at Samsung Medical Center has paved the way for restoring liver function in patients with late-stage liver cancer through the transplantation of a small liver lobe. This innovative procedure, led by Professor Jong-man Kim of the Department of Transplantation Surgery, marks the first successful surgery of its kind in Korea.

In November last year, a patient suffering from liver cirrhosis due to autoimmune hepatitis, and with cancerous cells in the right liver, underwent a groundbreaking transplant. Despite prior radiofrequency ablation to reduce tumor size, concerns about cancer recurrence led the patient to opt for a liver transplant.

A suitable living donor was found, and the surgical team decided to transplant the left lobe of the donor's liver. However, the left lobe weighed only 320 grams, equivalent to 0.6% of the recipient’s body weight. Typically, a transplanted liver needs to be at least 0.8% of the recipient’s body weight to ensure proper function. Recent studies, however, indicated that livers slightly below this threshold could still be viable for transplantation.

Given the urgency of the patient's condition, the surgical team proceeded with the transplant. Post-operative evaluations showed remarkable results. A CT scan performed seven days after the surgery revealed that the transplanted liver had increased in size by 45.3%, demonstrating significant growth and functionality. Additionally, the cancerous right liver was successfully removed, and the patient experienced no postoperative complications.

Traditionally, the safest liver transplants involve whole livers from brain-dead donors, often resulting in long waiting periods. When using living donors, the right lobe (comprising 60% of the liver) is preferred due to its size and lower associated risks. However, the availability and suitability of right lobe donations can be challenging.

The success of this small left lobe transplant opens new avenues for both patients and donors. Patients previously unable to receive a timely transplant due to donor size limitations now have a viable option. For donors, the reduced risks associated with donating a smaller liver lobe make the process safer and potentially more appealing.

"For patients with severe liver disease who have been waiting for a brain-dead liver transplantation without a suitable living donor, we have provided new hope. Utilizing a small left liver from a living donor can now be a viable solution," said Professor Jong-man Kim. "We hope that this donor-safe surgery will become a standard option, enhancing the quality of life for recipients post-treatment."

This innovative approach promises to revolutionize liver transplantation, offering a lifeline to many patients while ensuring donor safety. As research and clinical practices advance, the medical community anticipates broader adoption of this technique, further improving outcomes for liver transplant patients worldwide.