Allegheny General starts liver transplants

Allegheny General starts liver transplants
By Luis Fabregas
TRIBUNE-REVIEW
Friday, November 16, 2007


For three days Chrissie Berman felt nauseous and assumed she had stomach flu.
When she felt so sick that she had to call 911, she wound up at Allegheny General Hospital, where doctors quickly diagnosed her with an often deadly illness that stopped her liver from working.

"The next thing I remember is waking up and my mom telling me that I have a new liver," Berman, 28, of Robinson said Thursday. "I was in shock."

There was something else Berman didn't know: She became the first liver transplant patient at Allegheny General.

The hospital's program, AGH officials say, not only gives patients an option to the University of Pittsburgh Medical Center's long-standing program but is critical to accommodating the large number of patients with liver disease. AGH's center for digestive health, for example, refers up to 30 patients a year to other transplant centers.
Without this program, patients whose health insurance coverage doesn't include UPMC would be forced to travel out of state for a liver transplant, AGH officials said.

"We were sending patients away at a very frightening time," said Mary Ann Palumbi, senior director of transplantation. "They couldn't stay at the place where they're comfortable and where they've always received care."

AGH for years has had programs in heart, kidney and pancreas transplantation. The liver program, announced in 2006, has 10 patients on its waiting list, Palumbi said. Berman's surgery was Nov. 1. A second patient whose name was not disclosed had a liver transplant Nov. 8.

Berman was admitted to the North Side hospital Oct. 28. Doctors diagnosed her with fulminant hepatic failure, or acute liver failure, which happens when liver cells are injured and die. The cells are replaced with scar tissue instead of normal liver cells. A common cause can be ingestion of high doses of acetaminophen, often taken as Tylenol.

Dr. Thomas V. Cacciarelli, the surgeon who led the transplant, said tests haven't determined what caused Berman's illness and more tests are pending. "When the liver was taken out, it was pretty much dead," he said.

The severity of the illness bumped her to the top of the regional liver transplant waiting list. Within three days, she received a liver from an 18-year-old donor from Delaware. Cacciarelli performed the six-hour surgery along with Dr. Mark Roh, chairman of AGH's department of surgery.

Cacciarelli is a UPMC-trained surgeon who has performed more than 500 transplants and is director of the liver transplant program at the Pittsburgh VA Healthcare System.

"I'm pretty pleased with the way it worked out," he said.

Berman, who grew up in Crafton, is a stay-at-home mother to three: Gabrielle, 7, Tyler, 4, and Julian, 1. Her husband, Bradley, is a manager at Vocelli Pizza.

"It took a good day to actually sink in," said Berman, who long ago agreed to be an organ donor herself. "I never thought I would ever need a new liver."

After a two-week stay at the hospital, she is recuperating at home and doctors said she is expected to take anti-rejection drugs for life. The hospital will provide follow-up care, including continuous monitoring of her liver function.

"I can't rave enough about the quality of their care," she said. "They treated me like I was one of their own, like a family member. They could not have been any better."



Luis Fabregas can be reached at lfabregas@tribweb.com