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Domino liver transplant has first local success at Taipei Veterans General

TAIPEI, Taiwan -- The Taipei Veterans General Hospital (TVGH) recently publicized a successful case of a domino liver transplant performed last December, in which three people participated in a 12-hour operation.

Having liver metabolism problems, a man surnamed Chen accepted his son's liver donation and donated part of his own liver to a lady surnamed Huang, who has liver cancer. The operation broke medical records in Taiwan, being the country's first case and was able to save two lives in one day.

Chen, 60, reportedly was of good health until his lower legs failed to support his weight and often felt numb. He was later diagnosed with a rare disease, Familial Amyloidotic Polyneuropathy (FAP). The inherited disorder sometimes never manifests during many carriers' lifetimes; Chen being one of the rarer cases that proved otherwise and would need a domino transplant. Many of Taiwan's FAP carriers only discover the disorder after they are over 50, as the disorder develops slowly.

Although the liver removed from FAP carriers will continue to produce prion, it retains its original structure and otherwise functions normally. It can benefit elderly patients who have been waiting for a donor for many years.

Huang, 55, was said to be near death at the time of the donation, as she has Hepatitis C, cirrhosis and a liver tumor. Despite her child's wish to become her donor, a match had not found between mother and child, prompting the physicians to decide to use Chen's liver instead.

In order for the operation to work, the hospital enlisted the help of three teams of over 20 physicians.

Domino liver transplants, during which a patient undergoes a liver transplant and in turn donates his liver to another recipient, have been performed since the mid-1990s in other nations. The TVGH's first successful case had been in 2007, although one of the donors had previously been diagnosed as brain dead.

Domino recipients with nonmalignant indications for liver transplant show excellent long-term survival. With careful selection of recipients, the procedure helps to reduce the organ shortage and the time spent on waiting lists for patients with malignant disorders.

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