Toronto hospital performs first paired liver transplant with living donors in North America
In 2017, Muhammad Khan was feeling breathless, so he visited the emergency room.
At the hospital, doctors examined him and determined that his liver wasn’t working properly — he had non-alcoholic liver cirrhosis. “Then they told me that there’s no other way out other than to get a liver transplant, because my liver was going in a state of failure,” he said.
His wife, Hina Khan, said the news was shocking for the whole family.
“The doctor advised him to do the liver transplant but the waiting time was very long,” she said. “So we were on the list and the doctor told us that it would take three to four years.”
But while visiting Muhammad in the hospital, she saw a poster about living organ donation, where a living person donates a kidney or part of their liver to someone who needs it. Unlike most organ donations, which are performed immediately after someone dies, a living donation is just that — performed while the donor is still alive, and they can go on to live a relatively normal life after they recover from surgery.
After learning about living donation, Hina said, “It was not even a second thought for me, I just jumped in and said, ‘Ok, I will do that.’”
Unfortunately, she didn’t have the same blood type as her husband. He needed a liver from someone with Type O blood.
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That’s where Kelly Bryan came in. The 38-year-old mother of three from Peterborough, Ont., had seen someone looking for a living organ donor on Facebook. “Somebody was in need of it,” she said.
“They’re not my friend or family member but I looked into it and quickly considered it and applied to be their donor.”
She never got a call back about that case, but remained on the potential donor list, looking to donate a piece of her liver anonymously to someone who could use it.
Then last spring, she got the call and decided to donate. “We’re all called to help each other and really, so many people are capable of it and just don’t even know it,” she said. “But living liver and kidney donation is really an important thing.”
So, Kelly Bryan’s liver went to Muhammad Khan. And Hina Khan’s liver went to another patient, who decided to remain anonymous.
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That meant that when doctors at Toronto General Hospital went into surgery on July 9, 2018, they had to do four simultaneous procedures: getting the livers out of the donors and into the recipients as quickly as possible.
It required four surgical teams, four operating rooms, 28 staff and surgeons and 12 hours, according to the hospital.
It was “fantastic” according to Dr. David Grant, a transplant surgeon at the University Health Network, which operates Toronto General Hospital. He described the procedure as a “first in the Western world.” While paired liver transplants with living donors have happened in Asia, the hospital doesn’t know of any cases in Europe or the Americas.
“It usually takes someone anonymously stepping forward and saying, ‘I hear there are people in our community dying of liver disease,’ and wanting to donate part of their liver to kick this off,” he said.
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In the surgery, the donor gives up around 70 per cent of their liver. But — it grows back.
“That’s the unique part of liver donation,” Grant said. “If you donate a kidney, for example, you lose that kidney. Of course the other one still works well and provides near-normal function, but the beauty of a liver is it grows back to the same volume as before and function is completely restored to normal and there are no long-term health impacts.”
Bryan said that she feels back to normal now, less than a year after her donation. Her partner was supportive throughout her recovery, she said. “Without that kind of love and support you can’t do it.”
“I was in awe, like I am pretty much every day with her,” said her partner, Harold Westerman. “It’s naturally what she’s like every day. She likes to give. So it didn’t surprise me when she told me she wanted to do this donation.”
Bryan’s explanation is a bit simpler.
“I’ve had some pretty amazing people in my life who do amazing kind things for me and it’s just paying it forward.”
Muhammad Khan is grateful to Bryan for his new liver.
“I never knew Kelly. I’m not related to her. I’m not her friend. But I have the utmost admiration for her.
“I wouldn’t have been alive without her help.”
If you’re interested in learning more about becoming a living donor, the Canadian Transplantation Society has a list of local transplant programs on their website.
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