With the successful transplant of a segment of her aunt’s liver into a 1-year-old girl at University Hospital, home to the only living-donor liver transplant program in Central and South Texas – and currently the second largest living liver transplantation program in the nation – is now able to offer this lifesaving option to children with critical liver failure.
Six weeks after she was born, Alma Arellano of Brownsville was diagnosed with biliary atresia, a serious liver disorder in which the bile ducts aren’t working properly. Within days, she underwent surgery at University Hospital to restore the flow of bile from her liver.
While the surgery was a success, Alma’s liver rapidly began to fail. Because of her tiny size, a size-matched deceased donor liver to transplant into her would be extremely difficult, if not impossible, to find in time to save her life.
“She was literally slipping away from us,” said Dr. Francisco Cigarroa, University Transplant Center surgeon and the Carlos and Malú Alvarez University Distinguished Chair in Pediatric Transplantation Surgery at UT Health San Antonio. “Fortunately, as she was getting sicker and sicker, a relative stepped up to say: ‘I would like to be considered as a living donor for Alma.’”
Her aunt, Maria Casas, proved to be an excellent match. And on March 15, 2018, just three days after Maria was medically cleared, she became Alma’s lifesaving liver donor — providing a perfectly sized segment of her own liver. The liver is unique among organs in that it will regrow to the right size in both the donor and recipient after transplant.
University Health System’s Transplant Center has long offered the only living liver transplant program in South and Central Texas. Under the leadership of longtime Transplant Center director Glenn A. Halff, MD, the program grew significantly over the past year while maintaining outstanding outcomes for patients. The Transplant Center performed 30 living liver transplants in 2018, including Alma and one other pediatric patient. “We consider this a very important option for pediatric patients now,” Dr. Cigarroa said. “Because we feel children can ultimately do better with a living donor transplant than waiting and getting too sick to get transplanted.
“Unfortunately, children and adults with liver failure still die on the waiting list. Living donor transplantation is lifesaving for these patients,” he added. That is a large part of the reason why the team has worked so diligently to grow the program. The only program performing more of this highly specialized procedure is the University of Pittsburgh Medical Center in Pennsylvania.