SickKids celebrates 30 years of liver transplantation

This Thanksgiving marks the 30th anniversary of the first liver transplant at The Hospital for Sick Children (SickKids). As home to the largest paediatric liver transplant program in Canada and one of the largest in North America, SickKids has performed more than 530 liver transplants over the past three decades with unsurpassed success and long-term survival in North America.

There have been many medical advancements over the three decades. The first liver transplant at SickKids was from a deceased donor, and just 10 years later, in 1996, surgeons at SickKids and Toronto General Hospital, University Health Network collaborated on their first living donor liver transplant. This type of transplant involves surgery to remove a portion of the liver from a living adult donor, which is then transplanted into the child who is in liver failure.

“We have come a long way since 1986. Some of the major advances in liver transplantation have been thanks to the progress in surgical techniques, making living donation possible. Our approach to immunosuppression has also evolved. Contrary to popular belief, we are now in an era of immunosuppression minimization, or in other words - less is more,” says Dr. Vicky Ng, Medical Director of the Liver Transplant Program at SickKids.

People who have had organ transplants must take medications to suppress the immune system which prevents the body from rejecting the new organ. “Thirty years ago, patients had to take more agents, and the dosing of these drugs was far higher, and there were more side-effects. Today, not only are our patients taking smaller doses, but it is not farfetched to imagine a day when some liver transplant patients will not require lifelong immunosuppression. This would have been unimaginable when we started the program,” says Ng.

Amanda Onabajo, 25, is a graduate from the SickKids Liver Transplant Program. She was born with biliary atresia; a rare disease of the liver and bile ducts. In 1991, at just nine months old, she had a lifesaving liver transplant from a deceased donor. While she has had several health challenges along the way, including a unique form of transplant lymphoma, Amanda is a vibrant and positive young woman. Thanks to her liver transplant, she is not only living, but is living well. Amanda graduated from the University of Waterloo in June 2016, is working as a social services worker at a group home, and just bought her first car.

Last year more than 60 per cent of the liver transplants performed at SickKids were from living donors. Living donor organ transplantation is bridging the gap between the need for more lifesaving organs and the lack of organ availability. According to Dr. Ng, while this generosity is something to be celebrated, the preferred standard of care remains donation from a deceased donor.  

The Liver Transplant Program recently hosted a Family Education Day to celebrate its 30-year milestone. More than 150 patients past and present, as well as their families and friends, attended to learn about the progress that has been made and where the field is headed.

“While I don’t remember life before my liver transplant, I do think about the family who decided to donate their child’s liver to me. They saved my life and I am so grateful,” says Amanda.

To register to be an organ donor please visit www.beadonor.ca