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Czech IKEM first in the world to perform unique liver transplant

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Prague, March 7 (CTK) – The Prague-based Institute for Clinical and Experimental Medicine (IKEM) is the first in the world to perform a unique liver transplant on a woman with anomalously placed organs in the thoracic and abdominal cavities, IKEM spokesman Veronika Velcova told CTK yesterday.

The 58-year-old woman suffers from a rare anomaly since she has her heart and stomach on the right and the liver on the left side.
She received a new liver six weeks ago and was released home less than two weeks after the surgery. The technically challenging operation that lasted more than ten hours saved her life.
Despite the anomaly, the woman did not suffer from any serious troubles until 2005 when she was diagnosed with hepatitis C. The treatment was not successful and her condition was deteriorating.
“Doctors told me that I had cirrhosis. Last summer, they found a more than two-centimetre carcinoma in my liver,” the patient, Alena Dargajova, said.
The only solution was a liver transplant. However, it was very complicated due to the abnormal liver placement.
The new liver had to be modified first to fit on the left, Jiri Fronek, head of the IKEM’s Transplant Surgery Clinic, said.
“Eventually, I decided to adjust the liver from a dead donor into the required shape and size, using the reduction method, and then I turned this liver graft clockwise by 90 degrees to be able to connect it to the blood vessels and the bile duct,” Fronek said.
The patient spent 12 days in hospital, six of them in the intensive care unit.
One in 10,000 people is born with a similar anomaly in the world.
So far, 90 such patients have undergone a liver transplant. Only 12 of them were adults. Six received the whole liver from a dead donor and three got part of the liver from a living donor (one of them a left lobe).
The Czech woman is the first patient in the world with reversely placed internal organs to receive a liver graft from a dead donor, reduced to the left lobe.
Last year, IKEM performed 137 split liver transplants, which makes up 73 percent of these operations in the Czech Republic. Fourteen patients were under 18 years.

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