Transplant program offers greater access to care for liver disease
By: Jason Molinet
A surgical team with the Sandra Atlas Bass Center for Liver Diseases at North Shore University Hospital (NSUH) has performed Long Island’s first liver transplant, giving a 42-year-old Brentwood man with just days to live a new lease on life.
Carlos Rosales, a married father of two, underwent a complex 11-hour transplant surgery on December 4, after spending three months on a waiting list for a liver, which he received from a 19-year-old deceased donor. Mr. Rosales’ model for end-stage liver disease (MELD) score was 39 at the time (the worst possible rating is 40), indicating the severity of his progressive liver disease.
“I honestly believe Mr. Rosales would not have survived the week without this incredible gift,” said Lewis Teperman, MD, director of organ transplantation at Northwell Health and vice chair of surgery at NSUH. “He was hospitalized and in desperate need of a liver. It’s a somber moment anytime an organ becomes available, but one person’s sacrifice can result in the gift of life to countless others. In this case, I fully expect 15-year-old Jalynn and 11-year-old Brandon to have their father around for many years to come.”
Northwell Health, New York State’s largest health system, received approval in June from the New York State Department of Health to operate Long Island’s first adult liver transplant program. The Sandra Atlas Bass Center for Liver Diseases, led by David Bernstein, MD, Northwell’s chief of hepatology and head of the health system’s liver sub-specialty service line, is providing pre- and post-liver transplant services along with care for those suffering from end-stage liver disease to more than 100 patients.
Northwell Liver Disease Investments Help Add Transplant Capacity for Region
Of the more than 10,000 patients currently awaiting an organ transplant across New York State – including 1,100 in need of a liver – nearly half live in Northwell Health’s catchment area. There were more than 8,200 liver transplants across the United States in 2018 – 450 of them in New York alone, according to the United Network for Organ Sharing.
“Long Islanders affected by liver disease now have a choice for their care,” said Dr. Bernstein. “Quality of life can be as important as the quality of care given, so receiving treatment within a short drive of home matters. Northwell’s liver transplant program offers that and more, increasing the capacity of livers to be transplanted in the New York Metro region.”
Northwell’s liver transplant program will provide world-class care from the outset, utilizing new facilities and medical personnel in which the health system has invested. This year alone, NSUH opened a 13,000-square-foot, $26 million Surgical and Transplant Intensive Care Unit, renovated two existing operating rooms into state-of-the-art surgical transplant operating suites and made 50 additional hires to support the program, including its medical director Sanjaya Satapathy, MD, and transplant surgeon Elliot I. Grodstein, MD.
Back from the brink
Dr. Teperman led the transplant team through the historic first surgery. He was one of five transplant surgeons, two anesthesiologists, two pump technicians, eight OR nurses and scrub techs, two surgical residents and one anesthesia resident on hand during the overnight transplant.
Livers are typically the size of a human head. But by the time Mr. Rosales’ diseased liver was removed, it shriveled to the size of a fist, Dr. Teperman noted. Initial pathology results indicate iron disease or hemochromatosis, a genetic defect that may explain why Mr. Rosales’ grandfather died from liver disease and his nephew is currently living with it.
“My family has been by my side through this entire ordeal; I couldn’t have done it without them,” Mr. Rosales said. “I’m grateful for this second chance I’ve been given. Thank you to the donor family and the incredible team at Northwell Health.”
At a recent press conference, Mr. Rosales and his wife, Kenia, encouraged New Yorkers to become organ donors.