Surgeons behind Scotland's first live liver transplant tell of 15 hour operation

THE surgical team behind Scotland's first ever live liver donor operation have spoken about the 15-hour ground-breaking procedure that allowed a Scottish woman to save the life of her new husband.

Consultant surgeons Murat Akyol and Ernest Hidalgo led a 30-strong team of medics - including seven or eight experienced surgeons, as well as anaesthetists and nurses – who transplanted 60 per cent of Jennifer Foster's liver into the body of her husband Daniel.

New Zealander Daniel, 28 had Primary Sclerosing Cholangitis (PSC) and was on the transplant list, but had been given less than a year to find a donor.

His wife Jennifer, 26, said she "didn't think twice" about offering to be Scotland's first live liver donor despite a 0.5 to one per cent risk of the operation resulting in a death, and a 20 per cent chance of complications.

The operation had taken two years of planning and medics from the Edinburgh Royal Infirmary had travelled the world, visiting Canada, Europe and the Far East among other places, watching procedures and learning from experts.

On January 16, they put that experience into practice under the watchful eye of one of the world's leading liver transplant surgeons, Professor Bernard De Hempting, of Belgium.

Both operations started at the same time in nearby theatres, with Daniel being prepared while Jennifer was operated on.

It took five hours to remove part of the liver from Jennifer and a further 11 hours to insert it into Daniel.

Mr Akyol, who was in charge of the second part of the operation, said: "With Jennifer the operation was extremely critical.

"It makes us much more nervous when the person is fit and healthy and putting them in danger is unjustifiable.

"Daniel's operation carried far more risk for very obvious reasons. However, on this occasion we never encountered any surprises."

He added: "After four and a half hours the graft was ready to be implemented, it was very difficult to time this perfectly.

"Once the liver had been removed it needed 45 minutes to extend some blood vessels."

Mr Hidalgo said: "I must pay tribute to Jennifer she has been brilliant throughout all of this and without her it could not have happened."

Jennifer underwent three months of tests before the operation could take place.

She had to have the same blood type as Daniel, be of a similar size to him physically, and be fit and healthy.

Three other would be live donors have been referred back to their GPs by the ERI team to lose weight before an operation could go ahead.

She also had to undergo some psychological testing to make sure she could cope with the stresses of the procedure.

However, she has recovered extremely quickly and was discharged from hospital after just six days. Daniel has also been discharged allow his recovery has been slower.

The liver has the ability to grow back to its original size.

Jennifer, a student veterinary nurse met, who Daniel at Surfer's Paradise while travelling in Australia, said: "When I met Dan I knew liver transplant was a route he would have to go down, I just did not realise it would be so soon.

"I had heard about the live donor programme and got the information off a website. I had three months of tests, both physical and psychological, and all the time I was asked, 'do you still want to go through with this you can pull out at any time'."

Asked whether the prospect of the operation had frightened her family, she said: "It was human nature. It had never been done before and was a risky operation in many ways.

"But at the same time everyone could see how Dan was going downhill, he needed the transplant so the pros definitely outweighed the cons."

Daniel, who had married Jennifer in Fiji in May and lives with her in Ardossan, admitted he was reluctant to involve his new wife in the operation.

"As adamant as Jen was about doing the operation, it was the hardest thing I have had to do," he said.

"She asked me, 'If the shoe was on the other foot, what would you do?' I would have done it in a heartbeat. I made the decision to go ahead with it because I had 100 per cent faith in the surgeons here."

He added: "The ERI have been incredible, I can't find the words to thank these guys enough. Jen has saved my life, but these guys have given her the opportunity to do that. I will be eternally grateful."

grose@edinburghnews.com