Pioneering Liver Transplantation: An Overview of the UCLA Program

The Ronald Reagan UCLA Medical Center stands as a national leader in liver transplantation, having achieved a significant milestone of performing its 6,000th liver transplant, a feat documented by the United Network of Organ Sharing database. This accomplishment marks UCLA as the center with the highest number of liver transplants performed in the nation.

A Legacy of Excellence

The 6,000th transplant, performed on June 30th, was carried out by Dr. Ronald Busuttil, the founder of the program and the executive chairman of the department of surgery at the David Geffen School of Medicine at UCLA, as well as the chief of the division of liver and pancreas transplantation. Dr. Busuttil emphasized that this landmark reflects the dedication and talent of the UCLA team and highlights the critical importance of organ donation for patients awaiting life-saving transplants.

Johnese Spisso, president of UCLA Health and chief executive officer of UCLA Hospital System, noted that the UCLA Liver Transplant Program has performed approximately one liver transplant every other day in the 32 years since its inception, demonstrating the program's enduring commitment to patient care. This year alone, UCLA surgeons have performed more than 90 liver transplants.

The Early Days and Evolution of the Program

Dr. Ronald Busuttil vividly recalls performing his first liver transplant at UCLA Health. He was at his accountant’s office when he received a call about a donor organ available at St. Jude Hospital. In the early days, the window for organ recovery and transplantation was limited. Busuttil, along with two colleagues, embarked on the journey to St. Jude, but not before acquiring an Igloo cooler to transport the donor organ.

That first transplant on February 1, 1984, marked the beginning of what would become one of the most successful liver transplant programs in the nation. Over nearly four decades, Dr. Busuttil and his team have performed approximately 8,000 liver transplants, including over 1,000 in children.

Read also: Insights from Liver Studies

Comprehensive Patient Care

The UCLA Liver Transplant Program offers comprehensive care, viewing each patient as part of the UCLA family. The team works closely with patients before, during, and after the transplant, ensuring they are well-informed and supported throughout the process.

Pre-Transplant Evaluation

Before being placed on the liver transplant waiting list, patients undergo a thorough evaluation to determine their suitability for the procedure.

The Waiting List

Once accepted as a transplant candidate, the patient's name is added to the United Network for Organ Sharing (UNOS) list, where they await a matching donor organ.

Post-Transplant Care

Following a liver transplant, most patients remain hospitalized for about two weeks. The UCLA team provides comprehensive post-transplant care, including:

Physical Therapy: Many patients require physical therapy to regain liver function and overall strength.
Family Engagement: The team involves family members and caregivers, educating them on how to manage the patient's medical needs post-transplant.
Local Housing: The UCLA nursing and support team assists patients in finding local housing for their recovery period.
Long-Term Follow-Up: Patients receive ongoing follow-up care and monitoring from UCLA physicians for years after the transplant.

Why Choose UCLA Health for Liver Transplant?

UCLA Health's Liver Transplant Program stands out for several reasons:

Read also: UCLA Kidney Transplant Program

Excellent Outcomes: UCLA consistently surpasses national averages for patient and graft survival rates. As a Center of Excellence and a referral center, they treat patients with complex liver conditions.
Full-Spectrum Care: UCLA coordinates with various specialists to provide a comprehensive range of services through the Pfleger Liver Institute, offering care for all types of liver diseases.
Seamless Transitions: In collaboration with UCLA Mattel Children’s Hospital, they offer pediatric-to-adult care in a single setting.
Clinical Trials: Patients have access to promising new therapies through the research team, with many treatment protocols developed at UCLA now used worldwide.

Areas of Care

The UCLA Liver Transplant Program offers specialized care in several areas:

Adult Liver Transplants: The team has performed over 7,000 adult liver transplants and is internationally recognized for its pioneering treatments.
Pediatric Liver Transplants: The program at UCLA Mattel Children’s Hospital has performed over 1,000 pediatric liver transplants, making it one of the largest and most reputable programs globally.
Living Donor Liver Transplants: UCLA is one of the few centers in the western United States offering living donor liver transplants. Since 1993, they have performed over 100 of these procedures for adult and pediatric patients.
Hepatobiliary Surgery: Hepatobiliary surgeons collaborate with transplant surgeons and the Dumont-UCLA Liver Cancer Center to treat patients with liver disease, including those awaiting a transplant.

Conditions Treated

A liver transplant may be necessary if the liver stops functioning properly due to various conditions, including:

Autoimmune Hepatitis: The immune system attacks the liver, causing inflammation.
Cirrhosis: Healthy liver tissue is replaced by scar tissue, often due to alcohol abuse or hepatitis.
Cholangiocarcinoma: Cancer forms in the bile ducts.
End-Stage Liver Disease (Liver Failure): The liver can no longer perform its essential functions.
Hepatitis C: A liver infection caused by the hepatitis C virus.
Liver Cancer: Cancerous cells originate in the liver.
Combined Heart and Liver Disease: Patients with a history of Fontan procedure may develop liver congestion and fibrosis, leading to liver failure.

Innovative Care and Research

UCLA is committed to advancing liver transplant care through research and innovation.

NIH Grant for Immunosuppression Research

The Dumont-UCLA Transplant Center received a five-year grant from the National Institutes of Health (NIH) to develop medications that prevent the body from rejecting a transplanted liver, helping patients live longer and healthier lives. Dr. Jerzy Kupiec-Weglinski, the Paul I. Terasaki Chair in Surgery and vice chair of research at the Department of Surgery at the David Geffen School of Medicine at UCLA, leads this initiative.

Minimizing Rejection

UCLA has developed new treatments to minimize the risk of organ rejection.

Expanding the Donor Pool

UCLA's expertise in living donor liver transplants has expanded the pool of potential liver donors. They are one of the few programs performing "domino" transplants in patients with amyloidosis, further increasing donation opportunities.

Hepatitis C Treatment

UCLA is a pioneer in treating viral hepatitis C and managing pre- and post-transplant hepatitis C.

Research and Clinical Trials

The combination of an academic campus and a hospital allows UCLA to quickly offer breakthroughs and clinical trials to patients.

Expert Team and Personalized Medicine

UCLA’s liver transplant program has been among the top programs in the United States for over 25 years. The team understands the profound impact a liver transplant can have on a patient's life.

Patients choose UCLA for the experience and skill of its physicians, as well as the unique services offered. The program provides highly personalized patient care, with teams dedicated to meeting individual needs and offering support groups before and after transplant.

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