Murray • A Utah mom is hepatitis-free for the first time in 27 years, thanks to a live liver donation from her son. And the procedure portends more such life-saving operations at Intermountain Medical Center in the months and years to come.
On Feb. 6, Gwen Finlayson, 63 — the wife of retiring Springville police Chief J. Scott Finlayson — received the left lobe of her son’s liver. She’d been told “several times” over the years that she would eventually need a liver transplant. But she thought she could “muscle her way through,” until it became clear she needed the transplant soon.
It’s major surgery for both a donor and a recipient, but for 37-year-old Brandon Finlayson, the procedure was the second obstacle he had to overcome.
When he offered to donate part of his liver, “my first reaction was anger,” Gwen Finlayson said, “borne of fear for my son. I knew how big this surgery was; what he would go through. I didn’t want that for him. He wasn’t sick. He didn’t need surgery. I did.”
“I wasn’t surprised,” Brandon Finlayson said. “She just didn’t want to talk about it. She’s never wanted to talk about being sick. We all knew it was the right thing to do. It just took her a long time to get on board.”
Well, it took a few days, they added. “He finally convinced me,” Gwen Finlayson said. “I’m not quite sure how he did that. He’s always been rather persuasive.”
Manuel Rodriguez-Davalos, who performed the surgery, said he would prefer not to perform live-donor transplants, but not enough organs are available from deceased donors. (According to Intermountain, there are currently about 13,000 American awaiting liver transplants.)
“One of our leaders here at Intermountain told me, ‘We have a responsibility to help others help their loved ones,’” he said. “Even if it’s hard for us to operate on someone that’s healthy, we are helping them help their loved ones. It’s a concept of altruism that is incredible.
“I told Gwen, 'You're very important, but your son is the most important patient in the hospital.'”
“Amen to that,” Gwen Finlayson interjected.
Rodriguez-Davalos, medical director of Intermountain’s live-donor transplant program, got a bit of help from biomechanical engineer Rami Shorti and his team.
Using imaging of Brandon Finlayson’s liver, they created a plastic replica with a 3-D printer so Rodriguez-Davalos could plan for the surgery before the procedure began. “They get to look at and get insight from the model,” Shorti said.
“I love this,” Rodriguez-Davalos said. He even carries models in his back pocket and pulls them out to study before operations. “It gives you like a great visual of the anatomy.”
The Finlaysons’ surgeries were the first left-lobe, live-donor liver transplant in Utah. A spokeswoman for University of Utah Health said that system has performed right-lobe, live-donor liver transplants.
Studies have shown that left-lobe transplants are easier on donors because it represents about 40 percent of the organ. But they’re the exception, not the rule, in the United States. Why don’t all transplants use the left lobe?
“A lot of it has to do with how sick the patient is,” Rodriguez-Davalos said. “The sicker you are, the more liver you need. So the idea is that if you need a live donor, you should be doing them earlier.”
It's also a matter of anatomy, he said. Every liver is different, and the position of the blood vessels may make it safer to take the right lobe. “Sometimes it's the only option.”
In either case, the donor's remaining liver will grow back.
“The liver is an amazing organ. Within three months — so by now — Brandon's liver has probably regenerated 80 percent of what he gave,” Rodriguez-Davalos said. Eventually, it will grow back to its original size — perhaps even slightly larger than it was before the surgery.
And the so-far successful transplant is a sign of things to come. Rodriguez-Davalos said he expects to perform more left-lobe live transplants at Intermountain, and he expects that number to grow across the country.
“This is not only for [donors'] safety, but also the fact that they can recover much faster,” he said. “Some of our donors are going home in four or five days. Sometimes they're begging us to go home in three days because they all have this amazing personality.”
Brandon Finlayson is back at work, well on his way to recovery. Gwen Finlayson is taking medication to keep her body from rejecting her new liver and to prevent a recurrence of autoimmune disease. “But I’m happy to tell you at this moment I do not have autoimmune hepatitis. I do not have liver disease that I had for 27 years,” she said.
And she and her husband, Scott, plan to travel, spend time with their four children and 21 grandchildren, do volunteer work “and get on with life,” she said. “I look to the future with hope, instead of thinking, ‘How sick am I going to be then?’”