The NHS surgeons who saved 15 lives in record-breaking transplant op using just TWO donors



Surgeons are celebrating a European first with five lifesaving transplant operations from two donors in 24 hours.

In a stunning display of teamwork, NHS doctors and nurses gave hope to three seriously-ill children, including an eight-month-old baby, and two adults given less than two years to live.

Other organs were sent elsewhere in the UK to assist terminally ill patients. Altogether 15 people received the gift of life as a result of the marathon effort at two Birmingham hospitals.

From left, surgeon Paolo Muiesan, Sandie Lee Smith, Sean O'Brien, Professor Christophe Chardot, surgeon Darius Mirza, Angelica Marsh with daughter Lubaya, and surgeon Khalid Sharif

The operations included transplants of multiple abdominal organs into two patients - the first time this has happened in a day in Europe. Doctors also performed a 'domino' transplant, in which a live patient donates an organ after receiving a donor replacement, which had never before been attempted with the type of liver used.

Details of the transplants - all carried out on NHS patients - emerged as politicians on both sides of the Atlantic were embroiled in a highlevel row over the Health Service.

Tory leader David Cameron was forced to defend his party after an extraordinary attack on the NHS by his own MEP Daniel Hannan, who went on prime-time U.S. television to dismiss it as a '60-year failure' that he 'wouldn't wish on anybody'.

The medical teams in Birmingham were quietly confident that actions speak louder than words as they unveiled their remarkable results.

Transplant surgeon Darius Mirza, who led one of the teams involved both in retrieving organs from the two donors and the transplant surgery, said it was a team effort at Birmingham Children's Hospital and the Queen Elizabeth Hospital, Birmingham, involving up to 55 doctors, nurses and support staff.

Not only did local patients benefit, but at least ten other organs were sent all over the UK to help NHS patients, he said.

'It is an NHS success story and perhaps we don't give it the recognition it deserves because none of these patients would have survived two years without a transplant.'

Humbled: Mother-of-two Sandie Lee Smith (left) gave her diseased liver to terminally ill cancer sufferer Sean O'Brien (right) as she was given a new organ from a donor in a domino transplant

The marathon operation two months ago has transformed the lives of the two adults and three children who received organs.

In the stunning sequence of operations, the liver, bowels and pancreas from one donor were transplanted into a teenage boy. The stomach, bowels and pancreas from a separate donor were given to another young boy.

Half of the liver from this same donor went to a tiny baby girl, while the other half was given to a 30-year-old woman. Uniquely, the liver is able to regenerate itself after transplant.

In a unique 'domino' transplant, this woman's own liver was then transplanted into the body of an adult man, who was not allowed to a healthy organ.

The youngest recipient was eight-month-old baby Lubaya Turpin, who received half of a liver from one of thev anonymous donors.

She was born with a rare liver condition and underwent an unsuccessful operation at nine weeks. Her father Dwayne Turpin, 23, and mother Angelica Marsh, 22, from Birmingham, are delighted with the transformation.

Mr Turpin said: 'She's been like a different baby. We noticed improvements in just a couple of days. Her eyes used to be yellow and now they have cleared up. She has a lot more energy. She's been a very lucky baby.'

The other half of the liver went to Sandie Lee Smith, 30, who had endured a miserable six years since being laid low with the rare genetic condition Acute Intermittent Porphyria (AIP), which regularly left her in agony.





Sufferers do not produce enough enzymes to break down dangerous toxins in the body. This can lead to damage to the liver and regular 'attacks' involving abdominal pain and nausea.

Mrs Smith, from Cheltenham, Gloucestershire, said: 'The attacks meant I was going to hospital every month and then towards the end I was in hospital every week. I was in acute pain.'

The treatment she has received for four years was not effective and Mrs Smith, who works for a packaging firm, was put on the transplant list as a 'last resort' in December.

Six months later she received the other half of the donor liver - it will regenerate to full size over time - and is now looking forward to going on holiday and playing with her children Jamie, 11, and Tamzin, eight.

Mrs Smith said: 'I'm feeling loads better and have so much more energy than before. I can do things with my children, like take them away for a week somewhere, that I could never do before the transplant.'

As a bonus her liver, which she thought would be good enough only for medical research, was given to Sean O'Brien, 43, whose terminal condition made him ineligible for a completely healthy liver.

'I didn't think it would be possible to donate my liver to someone else, but I've managed to give Sean a better quality of life which is great,' she said. 'It was very strange meeting him because he has a part of me inside him.'

The unique feature of the domino operation is that it is the first time in the world that this type of liver - affected by porphyria - has been transplanted in such a way.

Naturally Mr O'Brien, who lives about 60miles away in Taunton, Somerset, is forever grateful. Although he spotted her on the hospital ward while they were recovering from surgery, they did not meet until this week.

Describing the emotional moment at Birmingham Children's Hospital, he said: 'Sometimes words aren't enough. I hugged her. I feel incredibly grateful, incredibly happy and incredibly humble.

'Everything is better for me now, my life is as good as I ever remember it being. Before I had the transplant I struggled to get out of bed or decide if I wanted tea or coffee. Everything became more and more difficult.'

Mr O'Brien collapsed in the gym four years ago. Tests identified a cancerous tumour the size of a grapefruit and 60 per cent of his liver was removed. In November 2007 a regular scan picked up another growth more than 9cm in diameter. Surgeons said it was too big to operate and Mr O'Brien was given drug treatment with debilitating side effects to keep the tumour at bay.

He was told the shortage of donor organs meant a transplant was not an option for a patient like him, at high risk of failing to survive, and he was forced to live under a death sentence. However, Mrs Smith's damaged liver gave him the chance to benefit from a 'domino' transplant.

Even though he risked developing AIP, his cancer would be cured. 'There was a high risk of rejection, but I had no alternative,' he said. 'I would have died.'

He was prepared for surgery in the room next to Mrs Smith and followed her into the operating theatre to receive her liver. 'After the surgery my wife said she'd never seen such a big smile from someone on a ventilator and I've been smiling ever since,' he said.

Because AIP mainly affects pre-menopausal women, doctors did not expect Mr O'Brien to suffer in the same way Mrs Smith did. However, a few weeks ago he suffered a painful AIP attack. He returned to hospital and drug treatment has prevented a repeat of the problem.

Mr O'Brien is married to Sam, 43, and they have a daughter Megan, 11. The couple own a spa and healthcare business and he hopes to be able to return to work soon.

The same donor also gave stomach, bowels and pancreas to an 11-year-old boy, who does not want to be named.

Mr Mirza said the transplants all took place over 24 hours in June, while other organs including four lungs, two hearts and four kidneys were sent to other patients on the waiting list.

He said the UK's record on donating organs for use after death could be better.

'We need people to be aware of how we can transform the lives of others. Only one in four of us is signed up to the NHS donor register. There is a lack of education and the system could work better across the board - there are many factors involved.'

Altogether 327 people have donated organs and 931 patients have received transplants since April, while 8,046 are still waiting. More than 1,000 people a year die on the waiting list. At least 150 people are waiting for a new liver at any time but they are all patients for whom time is running out.

The liver performs 100 complex functions, fighting off infection, making essential chemicals and filtering out poisons.

But when it goes into acute failure or is seriously damaged by cirrhosis, viral infection or even a paracetamol overdose there are no 'liver machines' to keep patients going.

The shortage of donor livers - like all organs - means surgeons have to make the most of what they have.

Uniquely, the liver consists of two lobes and can be split, with each lobe being transplanted into different recipients.

This is possible because the liver is the only organ that regenerates and will grow to almost full size over time, around eight years on average.

It is particularly useful in the case of child recipients, who can have a 'cut- down' liver which will then grow with the child.

Last year 636 liver transplants were carried out, more than 100 of which were split liver transplants.





How 55 staff worked together as one

IN total around 55 medical staff and support workers were involved in the multiple transplant operation with some surgeons and doctors taking part in up to four operations.

Consultant transplant surgeon Mr Paolo Muiesan led a team of doctors, anaesthetists and nurses during a six-hour operation to secure the organs from the first donor. These included the stomach, pancreas and intestine and two kidneys.

In addition a separate thoracic surgical team removed two lungs and a heart.

The liver was divided in half in the donor and then, like the other organs, individually packaged for transportation to the Children's Hospital and the Queen Elizabeth Hospital.

Consultant transplant surgeon Mr Darius Mirza led the team performing the transplant for an 11-year-old boy, using organs from the first donor. The six-hour operation involved the transfer of a stomach, pancreas and intestine.

Consultant transplant surgeon Mr Khalid Sharif led the transplant team giving a left half of the new liver to eight-month-old Lubaya Turpin. At the same time, at the Queen Elizabeth Hospital, consultant transplant surgeon Mr Simon Bramhall led the team giving the right half of the new liver to 30-year-old Sandie Lee Smith.

He then led the team performing the 'domino' procedure in which Sandie's liver was transferred to Sean O'Brien at the same hospital.

Simultaneously, Mr Mirza also led the team who retrieved the organs from the second donor, and carried out the transplant operation on 14-year-old Damien Simpson using those organs, the last of the five transplant operations on the day.

Each surgical team would consist of ten to 12 people.

At least four surgeons were needed for the retrieval operations, plus an anaesthetist, two technicians, two nurses, two coordinators and one theatre assistant.

The transplant teams consisted of at least one or two transplant surgeons, plus two assistant surgeons, an anaesthetist, two technicians, one nurse, one coordinator and one theatre assistant.