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 PIG LIVER HELPED SAVE
LINCOLN GIRL'S LIFE-- Lincoln Journal Star Autumn Tate has a special respect for pigs. If it weren't for a pig's liver, she wouldn't be alive today. In 1997, two days after her 16th birthday, Autumn went into a coma after complaining of lower back pain and flu-like symptoms. She was rushed to St. Elizabeth Regional Medical Center at 8:30 on a Sunday morning, then whisked by helicopter to the University of Nebraska Medical Center in Omaha. By 6 p.m. she was on a list awaiting a liver transplant. By 11 p.m., physicians decided to use a pig liver as a "bridge" until a human donor could be found. Her mother, Becky Tate Vandenberg, recalls seeing her daughter being hooked up to the pig liver, technically called extracorporeal liver perfusion. Med Center staff call it "liver in a bucket" or "liver in a bowl." The freshly harvested liver lay on a table beside Autumn's bed in a metal bowl covered with a sheet of clear plastic. Autumn's blood was pumped through a flexible tube inserted into her groin into a heart-lung machine to renew its supply of oxygen. Then it went through a warming canister to bring it back to body temperature and then into the pig liver, which turned bright red as it cleaned toxins from Autumn's blood before it was pumped back into her body through a tube under her collar bone.
"As long as blood is being passed through it, it keeps functioning," Vandenberg said. "It doesn't matter whose blood it is." At 12:30 the next morning, the family was told a human donor liver had been found. By 6:30 a.m., Autumn was in surgery, where she received a portion of the left lobe of the donor liver. The rest was used to save the life of a 51-year-old man. Autumn remained hospitalized for 50 days, during which time the human donor liver helped the remaining part of Autumn's own liver regenerate itself. Ultimately, the donor lobe was removed, and she went home with her own liver functioning normally. "I think it's wonderful that they could use the pig liver," Autumn said. "I feel there's absolutely nothing wrong with it, as long as it saves lives." Said her mother: "I said, 'I don't care - you do whatever you have to keep her alive. It doesn't matter if she grows a snout and a curly tail.' " Liver perfusions were inaugurated at the Med Center by Dr. Byers "Bud" Shaw in 1992. Doctors call the bowl that holds the liver a "Bud bowl" in his honor. Both pig livers and livers from human cadavers are used in the procedure, which often means the difference between life and death for someone awaiting a transplant, said Shaw. Since 1992, it has been used on 19 patients, 12 of whom received transplants. About an equal number of human and pig livers were used; in some cases, a patient first received a pig liver, then switched to a human liver before receiving an actual transplant. UNMC is a leader in liver perfusions, which have only been done at a few other hospitals in the world, said Lance Fristoe, chief perfusionist at the Med Center. Liver perfusions are only one way pig and other animal tissues are being used. Pig heart valves have been used for decades to replace human heart valves. In 1978, Lincoln heart surgeon Dr. Deepak M. Gangahar, president of the Nebraska Heart Institute, was the first Nebraska physician to insert a pig valve in a patient. Today, the use of pig valves - as well as other "biologic" valves constructed from cow heart valves or from human valves taken from cadavers - is routine. A pig heart valve is not living tissue, but performs a mechanical function, said Gangahar. The valves are treated to remove material that could cause rejection. "A common question is, 'Is my body going to reject that?' The answer is 'No,' " he said. "Basically, it's a nonliving valve." Researchers also have transplanted pancreatic islet cells from pigs to humans to treat diabetes, and pig neurons into the brains of Parkinson's disease patients. Individual-cell transplants don't have many of the rejection problems associated with whole-organ transplants. If researchers are successful in creating a safe pig liver that can function like a human one, Shaw said, he would consider using it. "I think it would be a wonderful thing. But we've got a lot of work to do before that can be a viable thing." Asked if she would have accepted a pig liver as a permanent transplant, if that had been the only alternative available, Autumn Tate had no hesitation. "I'd do anything to save my life," she said. Autumn lost most of a year of school because of her surgery, but graduated from Lincoln High School last spring with the rest of her class. She plans to attend the University of Nebraska-Lincoln and major in genetics, eventually heading for medical school. "I want to genetically alter humans and cure diseases before a child is born," she said. " I just want to save lives." Reach Bob Reeves at breeves@journalstar.com or 473-7212.
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