Philadelphia Inquirer - Children's Hospital of Philadelphia - 11

Monday, October 1, 2007 THE PHILADELPHIA INQUIRER www.philly.com veins. An accidental cut could damage the vessels beyond repair and at a minimum would increase the recipient’s risk of clots. Olthoff cauterized hundreds of tiny blood vessels as she cut through the liver. She tied off those that continued to bleed; otherwise, the donor could become unstable, jeopardizing all the organs. The liver is the only solid organ that can regenerate itself. Both the left and right lobes consist of four segments, and each has separate vascular and biliary systems. That enables surgeons to create two organs from one. In split-liver transplants, the right lobe is usually used for an adult, while the smaller left lobe — or a portion of it — is used for infants or young children. At 4:45 a.m., Olthoff indicated it was time to make the call. A Gift of Life donor program staffer, who would stay with her until she got back to CHOP, dialed the phone and held it to Olthoff’s ear to keep the surgeon sterile. Olthoff spoke first to Shaked, then to Kate Anderer, CHOP’s liver transplant coordinator. The left lateral segment of the liver was healthy and would fit, she said. Nadia should be taken to the operating room at 7 a.m. The transplant was a go. Elizabeth Rand, the liver specialist who had led the team treating Nadia for nearly a year, talks with anesthesiologist Mohamed Rehman while waiting for the diseased liver to be removed. She would add new samples from it to the scores of other livers she had collected since 1998 from CHOP transplants. A gift for others The surgeon turned back to the donor to continue the operation. Two hours later she was nearly finished. Several vessels were all that connected the left lobe to the right. Olthoff would complete the split back at CHOP. The other surgeons returned to the table. They clamped the donor’s aortic artery and pumped a cold preservation solution into the body, flushing out the warm blood. Transplant surgeons Kim Olthoff (left) and David Joseph prepare the donor’s liver as Abraham Shaked works behind them to remove the diseased liver. The surgery last month on another child was the same procedure that was done on Nadia. Department census There were 368 patients, including those in the following departments, during the midnight census: Operations performed Approximately 94 surgical procedures were performed. Some of the initial diagnoses were: 21 injury and poisoning 21 nervous system diseases 16 respiratory system diseases 12 digestive system diseases 8 musculoskeletal system diseases Diagnostic scans performed 78 MRIs 390 X-Rays 45 CT Scans Blood cultures Approximately 386 CBC tests were performed. Outpatient visits Approximately 4,100 patients were seen in the CHOP outpatient network, which includes: Emergency Room, Day Medicine, Day Surgery, Kids First, Primary Care Centers, Main Complex Specialty Care Visits, and Satellite Centers. 25 at 8 South 43 in the Pediatric ICU 54 in the Neonatal ICU 20 in the Cardiac Care Unit 24 in the Cardiac ICU Doctors and nurses on staff 1,003 Physicians 374 Residents and fellows 615 Nurses

Philadelphia Inquirer - Children's Hospital of Philadelphia

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