BOSTON--The United Network for Organ Sharing (UNOS) has awarded interim approval to Beth Israel Deaconess Medical Center (BIDMC) to conduct liver transplantation surgery. This approval serves as the regulatory foundation of BIDMC's multidisciplinary Liver Center. The Liver Center was created four months ago when Maureen Martin, M.D., was recruited to be the chief of the division of liver surgery and transplantation.
With the UNOS approval, BIDMC is now enrolling patients on the New England Organ Bank waiting list for donor livers. UNOS oversees organ donation and distribution policies in the United States and is under contract with the federal Department of Health and Human Services to operate the national transplant network. These responsibilities include coordinating the national donor organ recipient waiting list and establishing policies on organ allocation. BIDMC is in line for full approval from UNOS, which requires a vote by UNOS's board at its next meeting in May.
Other recent and notable developments for the center include the recruitment of Nazem H. Afdahl, M.D., to be the chief of hepatology, and Amadeo Marcos, M.D., to be the director of the living donor transplant program. Afdhal, the former chief of hepatology at Boston University Medical Center, is a leading medical expert in hepatitis C. He is the principal investigator of a national study aimed at determining if a tandem of two drugs can prevent liver damage from hepatitis C. Marcos comes to BIDMC from Virginia Commonwealth University, where he was director of the living donor transplant program. He conducted his first donor resection case in June 1998, and since then has performed the most adult living donor transplant surgeries in the United States.
Liver disease, while not as well known to the public as heart disease, is a significant national health problem due to the seriousness of its disorders and the numbers of people affected. It is the 10th leading cause of death in the United States. In addition, there are an estimated 3.9 million Americans chronically infected with hepatitis C, a disease that sometimes shows no symptoms until well advanced in its severity.
The BIDMC Liver Center utilizes a multidisciplinary approach to treating liver diseases and conditions, with an emphasis in four areas: liver failure, liver tumors, liver transplant, and viral hepatitis.
Liver failure program The liver failure program provides therapy for patients who are experiencing acute and chronic liver failure. Left untreated, liver failure can lead to coma, renal failure and cardio-pulmonary collapse. BIDMC has established the first dedicated Liver Intensive Care Unit on the East Coast. An integrated team of physicians and nurses care for liver failure patients using state of the art technology including new liver dialysis systems and cellular and organ transplantation. This unit also treats patients who are undergoing major liver surgery or who are recovery from transplantation surgery.
Liver tumor program The liver tumor program draws together a team of experts, including radiologists, oncologists, and surgeons, to bear on primary and metastatic liver cancers. Depending on the type of cancer, treatment options can include the surgical removal of the tumor, but this is limited to cases in which the rest of the liver functions well and there is no advanced cirrhosis. In some cases, the liver must be removed and replaced with a donor liver. Other treatments include chemotherapy, cryosurgery, chemoembolization and the use of microwaves, radiofrequency waves or laser energy to destroy the tumor.
Liver transplantation program The liver transplantation program team consists of nationally recognized surgeons who have expertise in adult living donor liver transplants, split and reduced size liver transplants and cadaver transplants. In addition, the surgeons collaborate with their Liver Center colleagues and members of BIDMC's Cancer Center to provide an aggressive multi-modality approach to non-transplant options with a particular interest in primary and metastatic liver tumors, radiologic and surgical portal shunting procedures, and complex hepatic and biliary reconstructions.
Viral hepatitis program The viral hepatitis program is focused on understanding how viral hepatitis B and C affect and damage the liver. The Center offers the latest in clinical therapy including trials of new long-acting or PEG-interferons that are given in combination with other anti-viral treatments. The program specializes in treating patients who are co-infected with both HIV and hepatitis C and in using new therapies to prevent progression of liver disease especially cirrhosis.
Beth Israel Deaconess Medical Center is a major patient care, research and teaching affiliate of Harvard Medical School and a founding member of CareGroup Healthcare System. BIDMC is the third largest recipient of National Institutes of Health research funding among independent U.S. teaching hospitals.