Dr. Sanjay Gupta: Son donates 60 percent of liver to ailing mom

Dr. Sanjay Gupta is a CNN medical correspondent and regular contributor to the weekend program "Your Health." Gupta, a practicing neurosurgeon, contributes health news stories to CNN.com. He joined the CNN.com chat room from Washington, D.C.

CNN: Good morning Dr. Gupta. Welcome to CNN.com Newsroom.

GUPTA: Hello, everybody!

CNN: Dr. Gupta, tell us a bit about the story behind the liver transplant at Georgetown University Hospital yesterday.

GUPTA: We had an exclusive look at a really remarkable gift yesterday. A 27-year-old healthy son donated 60 percent of his liver to his ailing mother, who was in dire need of a liver transplant. They are both expected to regain normal liver function within the next 8-12 weeks. More than just a bouquet of flowers, this son offered his mother a gift of life. Mothers always are responsible for creating their children's lives. It is a rare situation where a child can give that life back to his mother as we witnessed yesterday.

MORE STORIES Mother, son OK after liver transplant   Family undergoes living liver transplant     EXTRA INFORMATION • Learn more about the Linthicum family   • Find out more about living liver transplants

CNN: What were the risks to both the son and mother during surgery and what about during recovery?

GUPTA: It's a major operation. The operations took both of them14 hours each. Just to give you a bit of an overview, it was a carefully orchestrated day. First, the son went to the operating room and underwent a significantly risky operation to remove 60 percent of his liver, the biggest risk being potential bleeding. The mother's operation was started a few hours afterwards, and was carried out to the point just before where her liver could be removed. The liver was only removed after her son's donor liver was in her operating room. The biggest risk of both operations is bleeding, and the biggest challenge now, during the recovery period, is to be sure that the livers regain function, and begin to work, both son and mother.

CHAT PARTICIPANT: Will the son's liver grow back to its normal size?

GUPTA: That is precisely what the doctors who performed this operation tell us. It usually takes two to three months. The liver is one of the few organs in the body that is capable of regenerating itself.

CHAT PARTICIPANT: How often is this living transplant procedure performed in the U.S.?

GUPTA: There are two types of living donation, with respect to livers. Most commonly, it is performed from an adult to a child. The first adult-to-adult living transplant was performed in 1989. There have been approximately 400-500 performed since that time. The jury is still out as to whether more of these transplant operations will be performed, but many surgeons think they will be.

Mark and Dorothy Linthicum are recovering after surgery to transplant part of his liver into her

CHAT PARTICIPANT: Will the son have to take precautions about medications he might need during the re-growth period since the liver detoxifies nearly all drugs?

GUPTA: Excellent question. The answer is yes. Even during his post-operative period, his pain medication requirement will be significant, and certainly his doctors will be careful to prescribe medications that are not solely metabolized by the liver. Both son and mother will have their liver function tests checked regularly to know when their liver is back to full function.

CHAT PARTICIPANT: I have to ask what the liver provides in our systems that makes it so important.

GUPTA: The liver is responsible for too many things to name in one sitting, but some of the more important ones are metabolizing various products in the body, including blood breakdown products. It is responsible in large part for our ability to clot blood and stop bleeding. Liver enzymes also help digest food and break down fat. If the liver is not functioning properly, people can actually go into liver coma, because of the accumulation of toxic products, and this could lead to death.

CHAT PARTICIPANT: What type of blood or other matching is required between donor and recipient?

GUPTA: For the donor, they simply had to make sure they were the correct ABO blood match prior to the transplant. They also had to insure that the donor is healthy, and has no problems with his liver.

CHAT PARTICIPANT: What's the age limitation for the liver recipient?

GUPTA: While it is a criterion, there is no age limit for recipients. The procedure is more dependent on the physiological health and the chance that the patient will do well after this large procedure.

CHAT PARTICIPANT: Could either of them donate their liver after they die?

GUPTA: While living related transplantation is still a relatively new science, the situation will probably arise where people who have transplants may be asked to donate. Most surgeons I've asked feel that it's theoretically possible, but the technical challenge of removing a liver that's already been operated may prove too much. There is the added circumstance that liver transplant recipients receive through their entire lives immunosuppresant drugs that may take them off of potential donor lists.

CHAT PARTICIPANT: Is there any device that can be implanted to assist the liver in its function?

GUPTA: There are several different projects going on to try to develop what's known as an artificial liver. There has been some success with temporarily assuming function of the liver, but a permanent bio-liver is not available at this time. There are many various avenues of research to try to treat liver disease that range from the transplant of just liver cells to what is known as xenotransplantation, the transplanting of animal livers into humans. As of right now, all these projects are still in the research phase.

CHAT PARTICIPANT: Does this procedure have a chance of improvement through stem cell research?

GUPTA: Stem cell research may offer patients with liver failure an opportunity to actually grow an entirely new organ, thus removing the need for transplant donation. While it is no question a very exciting possibility, the stem cell research has not yet shown that solid organ creation... that we're there yet.

CNN: Do you have any final thoughts for us today?

GUPTA: Transplantation, since its inception, has created not only scientific, but also significant ethical challenges. The way the field continues to grow will depend on scientific and moral questions. What we witnessed yesterday was true benevolence and an opportunity for a son to prolong the life of his mother. There are currently approximately 18,000 people waiting for livers in this country, and best estimates say that maybe only one-third will actually get their livers. Living donation may be another option.

CNN: Thanks for joining us today, Dr. Sanjay Gupta.

GUPTA: Thanks for joining in.

Dr. Sanjay Gupta joined CNN.com via telephone from Washington, D.C. CNN is provided a typist for him. The above is an edited transcript of the interview on Wednesday, August 29, 2001.