Transplant surgeon’s innovative work is saving lives for more patients

[April 2010] At 1:30 in the morning on September 25, Lillian McLellan was home in bed listening to the wind outside bang the trash cans about while her husband was working the night shift. When the phone rang, she wanted to ignore it, but to this day she’s glad she got out of bed. A transplant coordinator from Yale-New Haven Transplantation Center (YNHTC) wanted her immediately. A liver was available for her.

McLellan lives 15 minutes away from Yale-New Haven Hospital (YNHH). Three years ago, anyone in Connecticut getting a similar call would have had to jump in the car or take the train to New York City or Boston for the operation.

Leader hits high marks

Sukru Emre has been particularly successful addressing liver donor shortages by performing cutting-edge surgeries.

Sukru H. Emre, MD, director of the Yale-New Haven Transplantation Center, came from Mt. Sinai Medical Center in New York in 2007 to head YNHH’s multidisciplinary program and provide the latest surgeries and clinical trials. Under his leadership, YNHTC surgeons have performed 104 liver transplants, 247 kidney transplants and seven rare pancreatic transplants.

Emre, a liver transplant specialist who performed his 100th surgery in Connecticut in February, has been particularly successful addressing liver donor shortages by performing surgeries such as:

• Split-liver transplants, using two sections of a single liver to serve two patients.
  
• Domino transplants, taking the liver from a patient who is getting a new liver to serve another patient with a shorter anticipated lifespan.
  
• Living-donor liver transplants, taking a section of a healthy liver from a living donor for transplantation.

According to the United Network for Organ Sharing, Emre’s one-year survival rates in pediatric and adult liver transplantation are 100 percent and 98.5 percent respectively, well above national averages.

A cutting-edge solution

Emre discusses cases with colleagues.

One patient who benefited from the changes in the YNHH program is Lia Cirelli from Redding, Conn., who was 11 years old in 2008, when doctors diagnosed her with a rare condition called Wilson’s disease. Copper buildup was causing her liver to fail, giving her only a few days to live. Her age and acute illness thrust her toward the top of the donation waiting list, but the first available organ wasn’t suitable.

Fortunately, a distant relative agreed to be a donor, and Emre had living-donor transplantation experience. On Easter Sunday of that year, Lia became the first child in Connecticut to receive a section of a living donor’s liver. Last year, she won an essay writing award and donated the money she received to the transplantation center.

A patient’s wait for an organ

McLellan, 58, had been experiencing health problems for years. She was diagnosed with hepatitis C in her 40s. The disease weakened her liver and she developed cirrhosis, then doctors found a malignant tumor.

Emre performs a liver transplant operation.

“I reached the point where I was out of breath, I couldn’t climb stairs, and I was bloated with water,” says McLellan, who was working as an administrative assistant at the time. “I went on disability because I had a cloudy head. When the liver is not working properly, there is poison inside the bloodstream that gets in the brain.”

In March 2008, Emre put McLellan on a waiting list for a liver transplant. More than once she got the call to come to the hospital to prepare to be a backup in case a patient before her on the list didn’t work out. Each time, she underwent the required blood work, chest X-ray and bacterial shower.

Walking every day

But the call on September 25, 2009, was the real thing. The operation took seven hours. The next day, her husband and son were amazed to see that her eyes were bright, her skin was clear and healthy, and the yellow was gone. In a few weeks, she was walking every day.

“At first I was slow and hunched over. With each passing day, I straightened up a little bit more,” she says.

Six months later, McLellan was taking the immunosuppressant drugs that she will need for the rest of her life. She was waiting for Emre to lift travel restrictions so she could fly to Arizona and see her grandchildren. “I’m getting back to my old self again, back to the old Lillian,” she says.

Story by Kathy Katella

Photographs by Robert A. Lisak