THE QUALITY of donor livers has deteriorated in recent years, an inquest into the death of a 29-year-old man following a liver transplant has been told.
Michael Burke of Oak Park, Tralee, Co Kerry, had a “super-urgent” liver transplant at St Vincent’s University Hospital, Dublin, on January 2nd, 2010, in a “heroic effort” to save the life of the father of three.
The transplanted liver failed to function properly after the procedure and Mr Burke developed multi-organ failure and died at the hospital on February 6th, 2010.
Dublin City Coroner’s Court heard the liver Mr Burke received, from the UK, was “suboptimal” and enlarged with some fat.
One of the problems with fatty livers is that they do not work as well, the inquest heard. This was the only available liver which matched Mr Burke’s blood group – and so had to be accepted.
When an individual is on the super-urgent list, doctors must accept the first available liver which matches the blood group.
Dr Donal Maguire, who performed the surgery, told the inquest the quality of donor livers has deteriorated in recent years. He emphasised that if the liver had not been available, Mr Burke would have died within 12 hours.
It was “a heroic effort to try and save somebody where the situation is they are going to die. I think it’s the right thing to try to transplant him and try and save his life,” he said. “He got a chance. It was the only chance that was out there. It was the only chance he was going to get.”
Coroner Dr Brian Farrell recorded a cause of death of multi-organ failure due to poor function of a transplanted liver as a result of a super-urgent liver transplant.
He recorded a narrative verdict, a summary of the facts of the case, and expressed his condolences to Mr Burke’s mother, who was in court with family members.
Mr Burke presented to Tralee General Hospital on December 29th complaining of pain in his stomach and vomiting. He was transferred to St Vincent’s hospital the next day with liver failure and placed on the super-urgent list for liver transplantation.
The possible causes of the liver failure were paracetamol and excessive alcohol intake.
The inquest failed to establish whether Mr Burke had taken a paracetamol overdose.
Heavier donors lower quality organs due to lifestyle
THE MAIN reason the quality of donor livers has deteriorated in recent years is because they are coming from heavier donors, according to transplant surgeon Dr Donal Maguire.
He said donated livers were considered of poorer quality if they were fatty, and more livers are fatty than in previous years, which was likely to be lifestyle-related given the growing levels of being overweight and obesity in society.
This was a trend which had also been noticed in the UK, he said.
Dr Maguire noted fatty livers can be transplanted because as a patient recovers after surgery “the fat problem reverses”. But they don’t always function quite as well in the immediate aftermath of transplantation, so are not normally used on very sick patients.
Appealing for more people to consider organ donation, he noted the number of liver transplants this year was down about 40 per cent on 2009. – EITHNE DONNELLAN