Thanks to a surgical innovator, transplant recovery times at Westchester Medical Center are now among the nation's fastest.
In late 2012, Ebony White, a hair stylist and single mother of three who lives in Brooklyn, noticed that her three-year-old son Laron Stevenson's eyes looked yellow. Suspecting jaundice, she took him to a local hospital, where tests were inconclusive. After a few days, during which he grew weaker and stopped eating, he was referred to Westchester Medical Center and its Maria Fareri Children's Hospital, where pediatric hepatologist Richard Rosencrantz, M.D., determined that Laron was suffering from liver failure. "Laron was a very sick little boy," said Dr. Rosencrantz. "We knew almost immediately that he would need a transplant." He then put him in the hands of one of the finest liver-transplant surgeons in the world.
Normally the operation takes anywhere from eight to 10 hours. But Youmin Wu, M.D., Chief of Intra-Abdominal Transplant and Hepatobiliary Surgery, has developed a technique called cavaplasty that has trimmed that down to three or four hours, reducing blood loss, speeding recovery and making liver transplants less of an ordeal for children and the elderly or infirm. Recently he introduced a further refinement he calls "modified cavaplasty," which maintains these shorter operating times while helping to keep patients more stable between the removal of the old liver and the introduction of the new one.
The most dangerous part of the procedure, when the new liver is taken off its ice pack but before blood flow is restored, has been shortened significantly with the new procedure. In a typical transplant, the liver is "off ice" about 40 minutes, Dr. Wu says . "With cavaplasty it is only 25 minutes, and my best time with the modified cavaplasty is 17 minutes," he says . Why do these numbers matter? For one thing, says Dr. Wu, they mean that "many patients who otherwise could not have undergone a liver transplant now can." One such patient, a man in his 70s, had been turned down at other medical centers because he'd had four coronary bypass operations and was deemed too frail. Dr. Wu did his transplant and reports that "the patient was so satisfied he made me a plaque as an award." Thanks to Dr. Wu's modified procedure, Westchester Medical Center is among a small group of hospitals leading the nation in recovery times. Typical liver-transplant patients stay in the hospital a week to 10 days; cavaplasty patients have averaged less than six days. Laron went home just four days after receiving his new liver.
Dr. Wu is an internationally renowned organ transplant surgeon who has performed more than 1,000 liver or kidney transplants, including transplant on a 19-day-old infant, the youngest and smallest live-donor liver recipient ever. He trained with the pioneer in the field, Thomas Starzl, M.D., the father of transplantation, who did the first liver transplant 50 years ago.
Because of surgeons like Dr. Wu, things have progressed exponentially. He performed 25 liver transplants between June and December 2013, "with a 100 percent survival rate," he says.
And as for Laron? "He's back to his old self, dancing to music and eating everything in sight," says his mom.