UCSF Liver Transplant Team Shares Expertise in Latin America

By Kate Vidinsky

Considered a model throughout Latin America, Uruguay’s liver transplantation program is marked by low patient mortality and high organ donation rates. That success is due in part to a UCSF team that shared its expertise and helped build the program in the small South American country starting back in 2007.

Claus Niemann

Claus Niemann

Previously, Uruguay had tried to go it alone, but high mortality rates soon caused doctors to shut the program down.

After their initial visit, the UCSF transplant team, including anesthesiologist Claus Niemann, MD, and surgeons Ryutaro Hirose, MD, and Peter Stock, MD, PhD, continued to consult with the team in Uruguay, guiding them through everything from patient selection procedures to the use of immunosuppressive medications following surgery. When it came time for Uruguayan doctors to conduct their first liver transplant since revamping the program, UCSF doctors oversaw the operation by dialing in via Skype.

“UCSF has cultivated a terrific relationship with Uruguay, and an enormous wealth of information has been shared along the way,” Neimann said. “I have been so thrilled to see this country succeed at something it was committed to achieve.”

Ryutaro Hirose

Ryutaro Hirose

The UCSF team has been particularly impressed by Uruguay’s high organ donation rates, which exceed those in the United States, Stock said.

According to Karina Rando, MD, a Uruguayan anesthesiologist who worked closely with the UCSF team to develop the program, children begin to learn about the process of organ donation at a young age.

“By educating people about the importance of organ donation very early on, we have been successful in demonstrating that being an organ donor is a very noble act,” Rando said.

Last week, the UCSF team returned to Uruguay, this time joined by Nancy Ascher, MD, PhD, chair of the UCSF Department of Surgery, for a three-day conference that brought together medical professionals from eight Latin American countries that aspire to build thriving liver transplant programs of their own. Participating countries included Costa Rica, the Dominican Republic, Ecuador, Mexico, Paraguay, Peru, Portugal and Venezuela.

Peter Stock

Peter Stock

During a phone interview between conference sessions, Hirose, the UCSF surgeon, remarked: “It has been so rewarding to witness the wonderful progress that Uruguay has made since we first became involved with their liver transplant program years ago.”

The conference offered workshops on patient selection and preoperative evaluation, surgical techniques and complications, and postoperative care. Special lectures focused on living donor transplantation and pancreas transplant surgery. The final session invited representatives from each country to discuss country-specific challenges and strategies to address them.

“We are seeing an explosion of interest from the attending countries in developing their own liver transplantation programs and I think everyone is truly inspired,” Ascher said at the end of the first day of the meeting. “We are sharing experiences and expertise, and I think we all are learning valuable lessons that we can take back home and apply to our own work.”

A world leader in organ transplantation since 1964, the UCSF Division of Transplant Surgery has performed transplants for more than 10,000 patients and has played a key role in defining the field.