The Organ and Tissue Authority (OTA) has drawn attention to local successes in split liver transplants as part of this year’s DonateLife Week campaign to increase organ and tissue donation registration levels Australia-wide.
Speaking to the ANMJ ahead of the annual initiative, which kicks off from 26 July, OTA CEO Lucinda Barry said that while the federal body’s surveys show at least 70% of Australians support organ donation, only one in three are listed as registered organ and tissue donors.
While Ms Barry acknowledged that factors like health, fitness or age also often stop people from registering to donate, she said these were often based on erroneous assumptions.
“The majority of people who say that they are too unhealthy are not too unhealthy to donate,” Ms Barry said.
For example, those with illnesses such as cancer can still donate their corneas, she said adding that concerns about age were often unfounded: The organisation’s oldest recorded donor was 87 years of age.
With the majority of organ and tissue donations coming from hospitals and around 2% of those who die in hospital getting the opportunity to donate their organs, Ms Barry noted that OTA focuses heavily on community engagement to increase public awareness of the organ donation process.
The DonateLife campaign is one portion of the OTA’s broader program of public outreach, and often uses the stories and insights those directly involved in surgical transplants, be it patients or healthcare professionals, to encourage more Australians to register their organs for donation.
Among those with an immediate connection to organ donation is transplant surgeon Dr Albert Shun, based at the Children’s Hospital at Westmead, NSW, who spoke to the ANMJ about the role of split liver transplants in helping to save hundreds of lives over the past three decades.
An innovation popularised in 1988 by German surgeon, Professor Dr Rudolf Pichlmayr, summarising the process of a split liver transplant is deceptively straightforward.
The two lobes of an adult liver can split between the right lobe (around 75% of the original liver size) and the left lobe (approximately 25%). When separating them, the child receives the left lobe and an adult the right lobe, with the liver able to grow and adapt according to the metabolism of its host.
“When you put in a liver that is too big for a child, you find that in about six weeks the liver will shrink quite a bit in size to what’s needed metabolically by the child, and then as the child grows, the liver grows with it… so it actually adapts to its environment,” Dr Shun explained.
The end result?
“You can save two lives with one liver,” he said.
However, while in 2018, split liver transplants made up more than half of the total performed liver surgeries on in Australia and New Zealand, one of the highest rates of paediatric split graft surgery in the world, Dr Shun notes that more livers are needed to ensure that the number of children waiting for surgery keeps decreasing.
“Waiting’s no good for their growth and for their brain development, for their overall psychological wellbeing and… family stress and everything else, so we still need people to donate their organs,” he said.
DonateLife Week 2020 runs from July 26 to August 2, with more details available on the DonateLife website. Members of the public also able to register as donors on the Australian Organ Donor Register online (Medicare card required)
In 1999 our 7 month old son received a left lobe of a split liver cut down as a mono-segment III graft. The right lobe of the donor liver went to an adult thus saving 2 lives with one liver. This split liver technique is known as the “Brisbane Method” and was pioneered in 1986 by Professor Russell Strong in Australia. We thank the Royal Brisbane Children’s hospital for their skills. Fast forward 21 years, our son is leading a Wonderful life. He has just finished his apprenticeship in the defence industry, he has an amazing girlfriend, loves to travel this great country, he has been the best man at a wedding and recently got to hold his newborn niece on becoming an Uncle for the first time. Our son and we his family are so very grateful to his donor and donor family the magnitude of what they have given him by way of a second chance is beyond words. Dr Jonathan Fawcett and his team at the Royal Children’s Hospital now known as the Lady Cliento Hospital are a humble team that have saved many Australian families through organ donation, heroes in every sense of the word doing these split liver transplants.