Rare transplant; Man received his wife's kidney and part of his son's liver

Doctors perform rare transplant

At the Hershey Medical Center, a man received his wife's kidney and part of his son's liver

By CHRIS SHOLLY
Staff Writer

Updated: 05/02/2011 04:58:41 PM EDT

http://www.ldnews.com/news/ci_17976156

HERSHEY - Surgeons at Penn State Milton S. Hershey Medical Center performed a rare, dual living-donor organ transplant on a 60-year-old Hazleton-area man last month.
Timothy Bradbury of New Boston received a portion of his son's liver and a kidney from his wife during a 19-hour operation on March 15 at the Derry Township hospital.
During a news conference with surgeons and the family Monday, Dr. Peter W. Dillon, chairman of the Department of Surgery, said the operation was the hospital's first simultaneous, dual living-donor liver and kidney organ transplant on a single recipient.
"It's been performed only 10 times in the continental United States since 1987," Dillon said. "Both of the donors, Timothy's wife, Mary Ellen Bradbury, and his son, James Bradbury, of New Boston, Pa., and the recipient, Timothy Bradbury are doing well."
Six weeks after surgery, James Bradbury's liver has regenerated to its full size, doctors said.
James Bradbury, 19, said he wanted to save his dad's life.
"This was a great opportunity for me to show how much I love my dad and also just to prove to myself what kind of person I am and what I would actually do for my family," James said. "It was a learning experience."
Mary Ellen said there was never any doubt about being a donor.
"The only question was how soon could we do this," she said. "We knew we had to do it, and we knew we were going to find a way."
She praised the surgeons for their caring and communication throughout the process. In addition, she said, she hoped more people would consider becoming donors.
"Up until this point, we never really gave it a thought, either. But if I could give something up, I'll gladly give it," she said, then added, "although the doctors tell me I'm pretty well done giving now. Hopefully, other families will understand. The outcome is definitely worth it."
Living-donor liver transplantation is a highly specialized and effective treatment for patients suffering from end-stage liver disease like Bradbury, Dillon said. Surgeons remove a portion of the liver from a healthy donor - in most cases, a family member or close friend.
Dillon said the nature of Bradbury's disease also required kidney transplantation, so his wife was able to give one of her kidneys to her husband. Doctors removed it through laparoscopy, a minimally invasive procedure.
Dr. Zakiyah Kadry, who performed the complicated double transplant, said doctors on the case did several tests on the family members to determine who, if any, would be best suited as donors.
Kadry said the operation required the talents of multiple specialists and much coordination.
"Whenever our liver recipients require kidney transplantation, we try to perform the two together because the risk of mortality is much higher if you perform a liver transplant alone," Kadry said.
She said the procedures started at 7:30 a.m. Tuesday, March 15, with the removal of a portion of James Bradbury's liver. The right lobe - about 50 to 60 percent - of his liver was removed and placed into his father.
"When we completed the live donor liver removal, we proceeded at that point with the removal of the kidney from Mary Ellen," Kadry explained. "Once we completed the implantation of the right lobe in Timothy, we then went ahead with the kidney transplantation. It did require a considerable amount of coordination."
For the donors, their operations lasted between six and seven hours. Timothy was brought into the operating room an hour after doctors began surgery on his son. Timothy was in the operating room between 18 and 19 hours, she said.
Dr. Ian Schreibman, assistant professor of gastroenterology and hepatology and medical director of the live donor liver transplant program, said Timothy's liver disease originated at birth.
"Timothy was born with complete obstruction of the ducts within the liver," he said.
The liver makes bile, which helps in the digestion of food, he added. The liver secretes the bile through ducts, or tubes and canals.
"It is remarkable that he managed to live to middle age since most people are not able to survive beyond infancy," the doctor said.
Schreibman said there were some consequences of the liver disease that became insurmountable, and Bradbury required a transplant. He said some liver diseases, such as Hepatitis C, can come back after a transplant.
"In Timothy's case, there should be absolutely no chance of recurrence of his liver disease, and he can be considered a true cure of his liver pathology," he said.
Other surgeons who were involved in the rare surgery included Dr. Nasrollah Ghahramani, assistant professor of nephrology, who recommended Bradbury receive a kidney as well as a liver, and Dr. Randy Haluck, chief of division of minimally invasive surgery, who removed Mary Ellen Bradbury's kidney.
Dillon said HMC's living-donor liver transplant program benefits patients on the liver transplant waiting list who have a higher-than-average risk of being unable to receive a transplant in a timely fashion.
"In Pennsylvania, there are nearly 1,500 candidates on the liver transplant list," he said. The hospital is only one of three in the state to offer this procedure, he added.


chrissholly@ldnews.com; 272-5611, ext. 151