August 26, 2009

"The List" and LDLT

The human liver is a remarkable thing.  A human liver is huge, relatively speaking.  About the size of a football, it's the largest internal organ in the body.  It's almost too powerful for what it does, all things considered.  In fact, a person can lose 75% of their liver (from injury, for example) and still live perfectly well.

Not only that, but amongst the liver's amazing properties is the ability for it to regenerate.  That unfortunate person who was reduced to having only a quarter of a liver can expect it to grow back to full size in about eight years.  Truly amazing.

Which brings up LDLT.

Momzerduck is beginning the process of being put on "The List", you see.  "The List", in this case, is for a liver transplant.  The all-high muckity-muck God-Doctor-Specialists finally realized that her long-term  liver problems have damaged her quality of life, thereby making her a potential candidate for transplant.  There's a whole battery of pre-qualifying tests she has to undergo, of course, but those are being scheduled.

Then comes "The List."  For people who aren't Steve Jobs, "The List" can easily be two years long, or longer.  This can be a problem, considering that often the reason a person is on "The List" is that they could be expected to die within a year if they don't get a transplant.  Fortunately, Momzerduck isn't in that category... yet.  Hopefully, she'll never be in that category, but one can't hope for that sort of luck.  So onto "The List" she goes, hopefully.

Of course, sometimes a person's standing on "The List" doesn't matter, and they need a transplant right-the-hell-now! or they won't be on "The List" any more, if you get what I'm saying.  Sometimes they even get bumped up "The List" and get a full replacement liver from a non-living donor, which is medical-ese of saying "recent corpse" or "motorcyclist on a wet road".

But then there are the times where right-the-hell-now! doesn't happen, and the person needing a transplant doesn't get it.  It's only been recently that such things as liver dialysis and Bioartificial Liver devices have come into being, and that can help extend the time limit in some cases (one dialysis device, cleverly named "The Prometheus Device" is currently in trials and seems to have quite a bit of promise), but such things are not yet as common as kidney dialysis.

Which brings us back to LDLT, or Living Donor Liver Transplantation.  The first successful LDLT was performed in 1986, at the Universidade de Sao Paolo in Brazil.  It was originally a method by which a parent could have part of their liver removed and that piece transplanted into their child, replacing the kid's bad liver altogether.  Along the way, though, doctors realized that, because of both the uncanny efficiency and the regenerative properties of the liver, it could also be performed on adults for adults.

Basically, the donor has about half of their liver (the right lobe, to be specific) removed.  That substantial chunk replaces the entire bad liver in the recipient.  Recovery time is about 4-6 weeks for the donor, during which time the liver gets back to full functionality.  Shortly thereafter, it'll regain its full size.  Meanwhile, the newly-transplanted portion takes over for the diseased liver of the recipient, and it too grows back to full size, though it takes longer for them.

Though Momzerduck objects, I've declared my intention to be a living liver donor for her if it comes down to that.  Of course, that's if I'm found to be a viable donor... what with The Incident and all, I may not be found to be healthy enough for what is a pretty huge procedure.  I'm afraid I surprised Momzerduck with my research on the matter; she didn't think I had  quite accepted the situation.

Recently, I've been making a lot of jokes about melon ballers and ice-cream scoopers.  Whistling past the graveyard, I think.  Hell, I'm scared spitless about the whole thing, to be honest.  In the immortal words of the Pythons in The Meaning of Life, "...but I'm still using it!"

But then, the alternative is worse.  A lot worse.

Posted by: Wonderduck at 09:00 PM | Comments (1) | Add Comment
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1 Best of luck to your mom and to you!

I understand that this trick of sectioning the liver also works with a non-living donor, benefiting two recipients.

Posted by: Ed Flinn at August 27, 2009 01:42 PM (RRq7w)

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