We have not recovered from a highly publicized death of a [liver] donor

[Clark]

http://www.ldnews.com/local/ci_25282014/liver-transplants-topic-lecture-at-penn-state-college

Liver transplants topic of lecture at Penn State College of Medicine Mini-Medical School
Doctor said almost 3,000 people a year die while waiting for a liver transplant
By Chris Sholly

For Dr. Karen Krok, one of the most interesting things about the human liver is the fact that it can regenerate itself.

"There are only two parts of our bodies that can regrow — the liver and the skin. Nothing else can do that. It's pretty amazing," said Krok as she opened her lecture on live donor liver transplantation Tuesday night in the Penn State Milton S. Hershey Medical Center's Junker Auditorium. Her lecture was the first in Penn State College of Medicine's 15th annual Mini-Medical School.

Started by the Office of Continuing Education 15 years ago, the school offers the public a chance to learn more about health and medicine. This year, more than 500 people have registered for the classes, and there are still some seats available. The one-hour classes run through April 2.

Krok is the medical director of the Live Donor Liver Transplant Program and an associate professor of medicine at the Penn State College of Medicine.

Krok said she became interested in working with patients who had liver disease because she "could make them better with a transplant. I just thought it was the most awesome concept."

Since 1990, there have been 5,031 living donor transplants in the U.S., Krok said. But, it still only makes up less than 4 percent of all liver transplants in the country, she added.

"In 2000, there was great enthusiasm for living donor liver transplants," she said. But the volume of these transplants declined dramatically by 2002. "The reason for that was a highly publicized death of a donor. We have really not recovered from that event" despite improvements in medicine.

Krok said there is a long waiting list of people who need a liver transplant and some of them will die while waiting for a transplant. Almost 3,000 people a year die while still waiting for a transplant, she said.

"We need to be finding ways to help our patients," she said.

Krok said some of the advantages of live donor liver transplant are that it optimizes timing for a transplant, frees up a patient from the waiting list and the preservation time for the liver is minimal.

"By definition, the person who donates that liver, they are healthy and they are young, and so that is usually a better quality liver than if you were to get one from a deceased donor," she said.

Krok said the live donor program has a comprehensive donor consent and evaluation process that takes into account the needs and concerns of the donor. A donor advocate is assigned to a potential donor, she said. Donors must also be between the ages of 21 and 65.

"They need to be healthy and they must be a volunteer. They cannot be paid for what they're doing," she added.

Krok said the majority of live donors are relatives, cousins, or spouses.

The liver has two parts, with the right lobe making up 60 percent of a person's liver and the left, 40 percent, she explained. Typically, a liver recipient will get the right lobe of a donor's liver.

"So, less than half of the donor's liver is left in their body," she said. "But, within a month, that liver will grow to almost its normal size in both the donor and the recipient."

Krok said there are risks with any surgery, but for live liver donors that risk is relatively low.