Radical Surgery: liver removed, reconstructed, re-implanted

A team led by Alan Hemming, MD, transplant surgeon at UC San Diego Health System, has successfully performed the west coast's first ex-vivo liver resection, a radical procedure to completely remove and reconstruct a diseased liver and re-implant it without any tumours.

The procedure saved the life of a 27-year old mother whose liver had been invaded by a painful tumour that crushed the organ and entangled its blood supply.

''During a 9-hour surgery the team was able to remove the basketball-sized tumour,'' says Hemming, professor and surgical director of the Centre for Hepatobiliary Disease and Abdominal Transplantation (CHAT) at UC San Diego Health System.

''This is a surgery that carries a 15 to 20 per cent risk of mortality. In this case, the patient would not have survived if she did not have surgery. This was the only way we could save her liver and her life,'' Hemming explains.

During the procedure, the diseased liver was detached from the body, flushed with preservation solution and cooled to a temperature of 4 degrees Celsius.  This allowed Hemming to carefully  remove the tumour from the liver in a bloodless field while preserving vital structures. Hemming then removed the tumour which weighed as much as the liver itself. Once the tumour was removed, the vessels were meticulously reconstructed. The liver was then successfully reimplanted.

''It was amazing to learn the tumour was so big and growing inside me,'' said Clerisa Keirsey, mother of three and Oceanside resident. ''I am glad Dr. Hemming was here to perform the surgery and happy to be going home to be with my children.''