One donor, two recipients: the first such liver transplant in Poland

In the Department and Clinic of General Transplantation and Liver Surgery at the UCK WUM, a pioneering transplantation of liver taken from a deceased donor and divided for two adult recipients has been carried out – the first of its kind to be performed anywhere in the country. This is another milestone in the Medical University of Warsaw’s transplantology program.

The operation (split liver transplantation) involved dividing an organ taken from a deceased donor and transplanting the right part of the liver for one recipient and the left part of the liver for the other recipient. The complexity of the procedure is reflected by the size of the team involved: 15 surgeons, two anesthesiologists, a radiologist, five instrumentalists and four anesthetics. That's over 20 people fighting for the success of a complicated procedure. Fortunately, both parts of the liver started functioning after being transplantated. The patients are in good condition, without any postoperative complications.

A chance to increase the number of transplants

"These types of operations make it possible to increase the number of transplants, which is of great importance due to the insufficient number of available organs," explains Professor Michał Grąt, the youngest head of a surgical clinic in the country, whose team pioneered the transplantation. "It is also an opportunity for liver transplantation for patients with low body weight, for whom the waiting time for surgery and the associated risk of death is significant. In this case, one liver taken from a deceased donor can save the lives of two people."

The beginning of the split liver transplantation program was a huge medical and organizational challenge, which could only be undertaken thanks to the experience of the team of the Department and Clinic of General, Transplantation and Liver Surgery UCK WUM in the field of liver and biliary tract surgery. The ability of transplanted liver fragments to function properly depends on many factors, including the implementation of complex vascular anastomoses ensuring good blood supply and outflow.

Teams that performed the operations

The implantation of the left segments of the liver was carried out by a team consisting of: Prof. Michał Grąt (operator), Dr. Maciej Krasnodębski (assist) and Dr. Adam Bołtuć (assist). Hepatectomy, i.e. removal of the diseased organ of the recipient, was performed by: Dr. Krzysztof Dudek (operator), Dr. Jan Stypułkowski (assist) and Dr. Andryi Zhylko (assist). The anesthesia was performed by Dr. Paula Dudek.

Implantation of the right liver segments was performed by a team consisting of: Dr. Piotr Smoter (operator), Dr. Konrad Kobryń (assistant), Dr. Emilia Kruk (assist). Hepatectomy was performed by Dr. Ireneusz Grzelak (operator), Dr. Marta Przybysz (assist), Dr. Emilia Kruk (assist). The anesthesia was performed by Dr. Jolanta Piwowarska.

The liver, collected from the deceased donor by Dr. Rafał Stankiewicz (operator) and Dr. Mateusz Bartkowiak (assist), was shared by Prof. Waldemar Patkowski, assisted by Dr. Paweł Rykowski. The transplantation involved a nursing team consisting of: Anna Wąsik, M.Sc., Katarzyna Wójcik, M.Sc., Karolina Kiełek, M.Sc., Marzena Kaczmarska, M.Sc., Joanna Petryka (instrumentalists) and: Joanna Kosińska, M.Sc., Patrycja Figarska, M.Sc, Agata Małek, M.Sc. and Weronika Karnkowska (anesthetics).

The entire transplantation procedure was coordinated by Krzysztof Zając.