Mother donates portion of liver to her 10-month-old daughter

A pediatric living-related liver transplant was performed in laparoscopy at ISMETT in Palermo.This is the first time in Italy that the left liver lobe was totally procured in a laparoscopy regimen. To date this technique has been used mostly for kidney procurement.

The surgery was performed on May 25 on Martina (fictitious name), a 10-month-old Sicilian baby girl. Since birth, Martina was affected by a severe form of cholestatic liver disease impairing her liver function. Transplantation was her only hope of survival. Her 20-year-old mother donated the left lobe of her liver. Living-related liver transplantation is a viable option because of the organ’s ability to regenerate. In just a few weeks time, both donor and recipient have a normal-size liver.

ISMETT's physicians discussed the option of living-related donation to the child's family considering the baby’s serious conditions. The mother immediately offered to donate her liver. It was decided to procure the left liver lobe in laparoscopy. Laparoscopy, used for a few years now for kidney procurement, is a much less invasive technique that reduces risks for the donor with a shorter recovery time than conventional surgical procurement. In addition, it affords a more detailed view of the liver’s anatomical structure making the procedure safer. The procurement was performed by ISMETT’s team in collaboration with the General Surgery and Transplant in Uremia and Diabetes Patients Unit of Pisa’s University Hospital run by Prof. Ugo Boggi. The portion of liver was isolated with instruments inserted through small holes in the abdomen and procured through a small incision over the pubis. The transplant followed immediately after. The procedure was a success.

Marta's mother was discharged 9 days after the procedure. The baby will be discharged in the coming days, she will stay in Palermo for a couple more weeks for the routine follow-up and then she will be able to return home. Dr. Marco Spada, chief of Pediatric Surgery at ISMETT explains, "mother and child are fine. The procedure was a success and Marta's liver has started to function properly. At ISMETT, for some months now we have started a mini-iinvasive laparoscopic surgery program performing very complex procedures. Laparoscopy liver procurement is a very complex technique used only in Europe and North America top centers."

ISMETT is one of the 11 centers in Italy authorized to perform living-related liver transplants and a center of referral for everything concerning pediatric liver surgery. In terms of both volume and quality of procedures, ISMETT ranks among the most active centers in pediatric liver transplantation. As Dr. Bruno Gridelli, ISMETT Direction, points out, "this mini-invasive technique makes liver donation more tolerable and safe. ISMETT continues its efforts to bring to Sicily advanced techniques and therapies in the field of transplantation and highly complex diseases. ISMETT is becoming more and more a point of referral not only for Sicilian patients, but also for other regions and countries.”