Mother of Twins Recovers After Unique Liver Transplant

Christine Mueller, a 32-year-old Whitefish Bay woman whose liver failed shortly after she delivered twin sons this month, has gone home. Her own liver was saved by a unique piggy-back transplant from a 17-month-old donor, performed March 13 at Froedtert Hospital by transplant surgeon Mark Adams, MD, Professor and Vice Chairman of Surgery at the Medical College of Wisconsin.

The transplant gave Ms. Mueller's liver a life-saving week to recover from acute failure caused by a complication of pregnancy, according to liver specialist Jose Franco, MD, Assistant Professor of Medicine.

"She suffered from acute fatty liver of pregnancy, which appears in milder form in one in every 7,000 to 15,000 pregnancies," Dr. Franco said. "However, the risk appears to be higher with twin boys."

Mueller became comatose within two days of delivery and was immediately transferred to Froedtert. The clotting factors produced by her liver were extremely low. She was on a ventilator and in kidney failure. A biopsy of her own liver, done at transplant, showed it to be more than 75 percent fat and her chance of survival to be less than 25 percent.

The donor liver was tucked under her own and attached to three of its blood vessels. Her own liver was not removed because patients with acute liver failure typically recover completely if they do not die immediately of liver failure.

Within 24 hours of transplant, she regained consciousness and her clotting factors returned to normal. The transplant was removed after one week, and a biopsy of her own liver at that time showed significantly decreased amounts of fat and that it had improved sufficiently to assure recovery.

The patient was able to be discharged on April 7.

"Her long term prognosis is excellent and she will not have any evidence of liver disease in the future." Dr. Franco said.

Mueller and her husband Robert, also have a 2-1/2-year-old son at home.

Dr. Adams said there have been fewer than 50 of these unique transplants worldwide. "Most have been done in Europe, using portions of adult livers because pediatric donors are rare," said Dr. Adams. "When this liver became available, no children on the local or regional waiting list were a match for it. The next step would have been to offer the organ to a wider region, but the woman was listed in the highest need category because she was so ill, and still would have had priority."

Other members of the transplant team include Allan Roza, MD, Associate Professor of Surgery, and Christopher Johnson, MD, Associate Professor of Surgery and surgical residents Maryam Parviz, MD, and Jason Evans, MD. The transplant coordinator at Children's Hospital of Wisconsin, primary care nurses and many other nursing, laboratory, operating room and support staff helped the transplant proceed swiftly and well.

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.