Phoenix Children’s Hospital announced the launch of a new Liver Transplant Program in affiliation with Mayo Clinic-Arizona, the only pediatric liver transplant program of its kind in the region. United Network for Organ Sharing (UNOS) – the organization that manages the nation’s organ transplant system under a federal government contract –granted certification this week.
Phoenix Children’s will be the first in Arizona to offer a full-spectrum, child-centered liver transplant program that will receive multidisciplinary support within the dedicated pediatric hospital. Each patient’s unique circumstances and needs will be addressed across the entire spectrum of care. This new liver transplant program will complement the hospital’s successful heart, kidney and bone marrow transplant programs.
Leading the program are two transplant specialists who have more than 20 years of combined experience in all aspects of liver disease and hundreds of successful liver transplants. Dr. Tamir Miloh, Hepatology and Liver Transplant Director for Phoenix Children’s, is the only board-certified pediatric hepatologist in the state. He currently treats more than 40 children who are post-transplant and more than 300 who are living with liver disease. He is joined by Dr. Winston Hewitt, a liver transplant surgeon for both Mayo Clinic and Phoenix Children’s. The two form the core medical staff for the Phoenix Children’s Liver Transplant Program and have assembled a dedicated liver transplant team, which also includes program coordinator Joy Anderson, RN. Transplant candidates will be evaluated by a multidisciplinary team including radiology, nutrition, social work, cardiology, palliative care and other specialties as needed.
“Bringing a pediatric liver transplant program to the Phoenix area will meet an unfulfilled need in the Southwest region,” said Dr. Miloh. “Historically, children in this area with complex liver conditions have needed to travel out of the Valley, to Tucson, Los Angeles, San Francisco, Nebraska or Texas for consults or transplants.”
Dr. Hewitt hailed the establishment of the new program saying, “All of the pieces are in place here at Phoenix Children’s to provide an integrated system of patient care, where the patient’s circumstances and needs are understood, communicated and addressed across the entire spectrum of care.” Both doctors expect the program to be extremely beneficial for patients and their families by offering a full range of services for those with liver disease, both acute and chronic, some of whom may ultimately require liver transplantation.
The liver is the largest solid organ in the body and performs numerous functions that are essential for life. The liver helps process carbohydrates, fats and proteins and stores vitamins. It produces bile and helps with the absorption and metabolism of nutrients absorbed from food in the intestines. The liver produces many proteins, hormones and other substances that the body requires to survive. It plays an important role in metabolism of most drugs and clearance of toxins and bilirubin. There is no effective artificial liver support, and in the setting of a failing liver, a liver transplant remains the only option for these ill children. There are many indications for liver transplantation in children. Biliary atresia (progressive scarring of the biliary system in newborns) is the most common indication. The biliary system creates, transports, stores, and releases bile into the duodenum to help in digestion. The biliary system includes the gallbladder, bile ducts and certain cells inside the liver, and bile ducts outside the liver.
Liver transplants are unique because the liver is the only organ in the body that can regenerate itself. Thus a liver transplant may involve the whole liver, a reduced liver or a liver segment. Most liver transplants involve the whole organ, but segmental transplants have been performed with increasing frequency in recent years. This may allow two liver recipients to be transplanted from one donor. A reduced-size liver transplant may be required if the donor liver is too large for the recipient. Living donor liver transplantation involves the removal of a part of a healthy donor’s liver for use in a patient with liver disease. This has assisted with the timely transplantation of children with liver disease as the deceased donor organ pool is limited.
One in 10 Americans has been affected by liver disease. According to UNOS, about 17,000 Americans are on waiting lists to receive a liver transplant. Approximately 600 children a year are undergoing liver transplants. The patient survival exceeds 90 percent in the first year and 85 percent after five years.