Children’s Hospital Colorado is asking healthy adults to consider giving a piece of their livers to get kids off the transplant list.
Typically, that list fluctuates between four and 10 kids at any time, but fewer livers have been available from deceased donors this summer, which created a backlog, said Dr. Megan Adams, surgical director of pediatric living donor transplantation at Children’s.
It’s not clear why liver donations have dropped off, she said.
If some of the waiting kids don’t receive a liver soon, they could become too sick to undergo the surgery, meaning they’d be out of treatment options, Adams said. Most of the children on the waiting list were born with malfunctioning livers or bile ducts, which connect the liver to the small intestine. Others have autoimmune diseases that damaged their livers, or metabolic conditions that could be cured by a transplant, she said.
“These kids that are waiting now are kind of at the mercy of the universe,” she said.
Donor Alliance, which coordinates organ procurement in Colorado, said 13 children have been listed for liver transplants so far this year. It’s not clear how many are still waiting at this point. The waitlist number varies from day to day as additional people become sick enough to qualify for a transplant, or are removed from the list when they receive one, become too fragile for the surgery, or die.
Over the last decade, the number of children on the waitlist for livers in Colorado at some point in any given year has ranged from 15 to 31, according to Donor Alliance.
People can donate two organs while still alive: kidneys and livers. Humans can survive with only a partial liver, so the recipient can be cured without harming the donor. The liver, in an average-sized person, is roughly the size of a football and weighs about 3 pounds, according to the Centers for Disease Control and Prevention. The amount that needs to be taken depends on the size of the recipient; a baby would require tissue about the size of a small Belgian waffle, Adams said.
The liver regenerates if part of it is removed, making the process safe for donors, Adams said. There isn’t much long-term data on outcomes, though a Korean study found some increase in mortality compared to the general population. It’s possible that American results would be different, though, since countries set their own standards for deciding who can be a donor.
Donors must be between the ages of 18 and 55, generally healthy and not obese, Adams said. Those who sign up undergo two days of testing to look for any health issues they don’t know about that could be aggravated by the surgery. Donors can choose to back out at any point before the surgery if they aren’t comfortable, she said.
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“As much as we want to get kids off the waitlist, the No. 1 priority is donor safety,” she said.
Children’s — which is the only hospital to perform pediatric liver transplants in the state — recently acquired a surgical robot that allows for a smaller incision and shorter recovery time, Adams said. With the robot, most people stay in the hospital for two to four days following the surgery, she said.
Colorado allows businesses to claim a tax credit to cover employees’ salaries for up to 10 days so they can offer paid time off to living donors, but businesses aren’t required to do so.
Unlike some organs, livers don’t require careful genetic matching. Children over a year old only need to be matched with donors by blood type, and infants can receive a liver donation from anyone, because their immature immune systems won’t attack different blood types, Adams said.
“If we could have 10 people step forward and donate to these kids, that would be amazing,” she said.