2018-02-08 / Business

Living donors are sometimes the difference between life and death

By Gary Gould
810-452-2650 • ggould@mihomepaper.com

DETROIT — Most organ donors are deceased when they give the gift of life to someone in need, but there are a select few who are able to give a portion of their liver and go on to live a normal life.

Dr. Marwan Aboulijoud, living donor transplant surgeon at Henry Ford Hospital in Detroit, said he has been doing liver transplants now for 24 years – and since 2000, he has performed all of the hospital’s living donor liver transplants.

He earned his medical degree from the American University of Beirut. His post-graduate training included the University of Michigan Hospital in general surgery, Henry Ford Hospital in general surgery, University of Alabama in Birmingham in transplant surgery and Baylor University Medical Center in transplant surgery.

Aboulijoud said he started in transplant surgery in 1992, and he started his practice in 1994.

“I wasn’t originally going to be a transplant surgeon,” he said. “I started out in plastic surgery. Putting fingers and tissue back together. But there was a bigger practice, which had a bigger scope – doing cosmetic work. That was not the passion.”

Aboulijoud said he had spent time working on the transplant service at the University of Michigan Hospital and he saw how sick people who suffered from organ failure were.

“They were dying right and left, and we could do something and they would live,” he said. “To save a life that quickly, something got in touch with me, it connected. Seeing the quality of life switch from most serious to improved just from receiving a new organ…that was very impactful.”

So Aboulijoud pursued a career in organ transplant. He was instrumental in moving Henry Ford Health System toward doing living donor transplants. While the hospital had been doing kidney transplants, taking a healthy kidney from a live donor and transplanting it in a patient whose kidneys were failing, split liver transplant wasn’t around until 2000.

Aboulijoud said Henry Ford Hospital “flipped the switch” in 2000 and brought its living donor program online.

Out of the approximately 110 liver transplants done at Henry Ford Hospital last year, nine were living donors. Aboulijoud said it takes five people to get to one suitable donor. Selecting a living donor takes meeting a lot of criteria, starting with anatomy or size.

“Do you have enough to give?” he said. “Are we leaving enough behind to regenerate?”

Aboulijoud said the liver is unique in that once you get blood flow into it, and as long as it is healthy, the liver will expand to certain size, usually about 90 percent of what the original size was. This allows doctors to take a portion of healthy liver from a living donor and transplant it into a recipient. The organ will regenerate in both patients.

Other factors considered in the screening process for a living donor is whether the blood vessels in the liver split right to left? Is the donor healthy? Are they a blood group match for the recipient? Do they have health problems?

An independent donor advocate looks over each case for a donor to determine if the donor is suitable for the recipient.

“It makes sure there is no bias or that we are not cutting corners intentionally,” said Aboulijoud. “It keeps us honest.”

When considering a potential living donor, Aboulijoud said they at age, requiring donors to be 18-55, tough occasionally older donors are accepted if they are healthy, have no medical history and have no history of heart disease or diabetes.

He said they perform CAT scans and an MRI, then do blood testing. In this process, sometimes they find health conditions the donor did not know he or she had.

“We’ve found liver tumors, found diabetics and sometimes we come across significant disagreement in the family about whether someone should be a donor,” he said. “The donor’s emotional well-being, psychological profile, recovery self-care. If they don’t meet the requirements we do not do the donation procedure.”

At Henry Ford Hospital, he said they have never lost a living donor. The survival rate for living donation is 100 percent.

Living donation is considered mainly in the worst cases, where time is essential for a patient who is dealing with a rapidly failing liver. Aboulijoud said the time from when an individual is listed as a potential recipient, it could take months to receive a traditional donation. But the wait-time for a living donation is far less.

Recovery for the donor is about three months. The donor is in the hospital about five days, and the donor can usually drive a car within a week and go back to desk job within three weeks. For a manual labor job, the recuperation time is about 4-6 weeks.

Aboulijoud said one consistency he sees in living donors is how amazing these individuals are.

“These are living people, sometimes from family life, they have gainful employment, but they take time to save someone life,” he said. “As far as I am concerned you are a hero and angel and you’ve earned your wings. You don’t have to prove what kind of person you are.”

Aboulijoud said Henry Ford Hospital has started the Center for Living Donation this year. Part of the center’s purpose is how to promote donation, promote donors, how to take care of patients during the donation process and long term.

The center will provide accommodations for donor families, educational materials, will work to alleviate myths, and of course, it will perform the living donor transplants.

Aboulijoud said ultimately, the message should always be to sign your organ donation card, while you are healthy.

Aboulijoud said always check with the transplant center rather than relying on information about organ donation from the Internet. Details: Call 800-436-7936.

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