Hear from patients who received the first domino liver transplant in decades at UNC Hospital

Seth Webb's story

When Seth Webb was born, he faced many challenges.

He was first diagnosed with a rare genetic disease known as maple syrup urine disease. His body lacked an essential enzyme needed to break down amino acids, the smallest building blocks of proteins. If you consume protein. Amino acids could overwhelm his body and put his health at immediate risk. He spent his life monitoring the amount of protein he consumed each day.

Webb later received a different diagnosis. Type I diabetes is a condition in which the body's own immune cells attack cells in the pancreas that produce insulin, an important glucose hormone. Webb adjusted her diet again and added insulin to her daily regimen. He subsisted on vegetables and protein supplements to keep his nutrition balanced.

But Webb did not let his circumstances defeat him. He and his family adapted instead. As a child, his mother carefully prepared his meals to ensure he ate enough and avoided trigger foods. Other than that, Webb lives a normal and fulfilling life. He has worked at a flower shop in the small town of Pinetops, North Carolina for the past 14 years, and has a wife and young son.

But despite her best efforts, Webb experienced multiple complications in 2023. As a result, he and his wife were always full and prepared for a 90-minute drive to the intensive care unit at UNC Hospital in Chapel Hill. It seriously interfered with his livelihood, often forcing him to take weeks off from work at a time.

During a recent visit, he asked his metabolic specialist if he could talk to someone about getting a liver transplant. A new liver will allow his body to metabolize protein again, reducing his long list of dietary restrictions. Because his disease was genetic, his old liver was otherwise healthy and able to go to people in need.

“I said, 'Before I leave here, someone needs to talk to me about the transplant,'” Webb said. “Dr. Oren Fix had a caring look in his eyes, like he really wanted to help me run and get through all the tests.”

Scott Owen's story

Scott Owen was diagnosed with a common form of liver cancer in 2010 while living in California.

Mr Owen, 58, had undergone at least 14 different surgeries to remove cancerous tissue from his liver and limit its spread. However, I was told that eventually surgery would no longer be able to prevent the cancer and I would need a completely new liver.

“The doctors told me I would have to wait until the cancer grew to two centimeters to get on California's transplant list,” Owen said. “At the time, I was told that due to my age and the high demand for viable livers in California, I would probably die before receiving a liver.”

Owen moved to Cameron, North Carolina in 2021 to be closer to his daughter and son-in-law who were stationed at Fort Liberty. As soon as Owen stepped foot in the Tar Heel State, he was placed on the organ transplant list and underwent all the necessary tests. A year later, he received a phone call he'll never forget. I was told that my new liver was ready.

domino liver transplant

Dr. Shirag Desai, FACSabdominal organ transplant and hepatobiliary-pancreatic surgeon at UNC Hospitals; Oren Fix, MarylandDirector of Liver Transplantation, UNC School of Medicine, UNC School of Medicine Transplant Team surgerywas given the opportunity to perform a rare domino liver transplant at UNC Hospital last November.

This will be the first time in 20 years that a surgery will be performed at the Chapel Hill operating room.

The first part of the procedure is the same as in classic cadaveric liver transplantation. Webb's healthy liver was carefully removed, “flushed” and placed in a special cooler filled with ice to keep the organ at the right temperature for preservation. Immediately after the liver was removed, a new liver from a deceased donor was carefully placed into Webb.

At the same time, Webb's original liver was immediately taken to an adjacent operating room, where Owen was removing the damaged liver. After a critical moment, Owen's new liver was safely transplanted surgically.

Desai and his team meticulously performed the surgery over a period of 20 hours, without any blood transfusions. This was an incredible feat, considering that abdominal surgery involves cutting and reconnecting a complex network of blood vessels leading to and from the liver.

Recovery after receiving the gift of life

Approximately 10 days after surgery, both patients were discharged from the hospital and able to return to their families.

“It's a little suffocating here,” Owen said. “The service and kindness I received and the concern everyone had for my recovery was amazing. I cannot express enough how happy I am with the process through UNC. It's not enough.”

Then home treatment began. As is the case with all patients receiving a new organ, Webb and Owen were given lots of painkillers, anti-rejection drugs, and strict instructions on how to cleanse their new liver system and keep it in working order. was given. Owen's wife, Lori, described what it's like to help her husband through his recovery process.

“When you're given all these medications and instructions, you start to realize that this man's life is now in my hands,” she says. “Your role is very important, but difficult. You feel left out while your loved one is recovering.”

“No matter the pain, sleepless nights, or long days of recovery, know that your symptoms will get better. And they will appreciate everything you do. Caregivers and Patients For us, there is light at the end of the tunnel.”

A year later…

Since receiving his new liver, Webb's life has improved in ways he never could have imagined. For the first time in his life, he was able to eat barbecued meat, a staple of North Carolina cuisine. He was so excited to try the cheeseburger with his young son.

“Not having to think about what you're going to eat for every meal is such a gift,” he says. “My menu is now just salads and vegetables, so I can try new foods with my growing son. In a way, it feels great to find food that I can eat without having to struggle.”

And, perhaps more importantly, he doesn't feel like he's a burden to others.

“Before I got my new liver, I did everything I could to just feel better so I could go to work and be there for my family,” he said. “I'm the type of person who doesn't want to bother anyone. I'd rather not have someone help me than have them help me. Otherwise, I feel like I'm inconveniencing them.”

A former carpenter, Owen, now 72, has returned to woodworking and now helps plan and construct new buildings at a local food pantry. He takes special care of his new liver and advises others to stay in good health going into surgery and not to give up hope, as it will also help with the recovery process. Masu.

“Keep the faith,” he said. “If you're in the program, you have an angel sitting on your shoulder and your liver is there for you. You have a chance to live a normal life again.”

Domino transplants have become more common since a new national policy called the Acuity Circles Policy changed the way organs are shipped to hospitals across the United States. Liver is harder to come by than ever, especially in rural areas.

Because livers are in high demand and in limited supply, many patients must wait until their condition worsens before they can be added to a transplant list long enough to receive a new organ. Domino liver transplants are needed now more than ever to alleviate the nation's liver shortage.

“We are very pleased that our team has the ability to perform such a complex surgery safely and effectively,” said UNC Hospital's Chief of Abdominal Transplantation and Liver Transplant Program. said Desai, who is also the chief of surgery. “These surgeries will give North Carolinians access to transplants and cutting-edge technology.”

Media contact: Kendall DanielsCommunication Specialist, UNC Health | UNC School of Medicine