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Sixty-two-year-old Harold Turner and 18-month-old Cesar Sepulveda, who were transplanted with portions of the same liver from a deceased donor last week, met for the first time today. Both patients are recovering quite well after undergoing the county's first split-liver transplant.

This procedure, performed on July 7, was the first split-liver transplant to be performed south of Los Angeles, and Cesar's transplant was only the county's second pediatric liver transplant. UCSD Healthcare surgeons and physicians said the patients are recovering better then anticipated. "Both of these patients will be discharged much sooner then expected," said Ajai Khanna, M.D., UCSD Healthcare's director of pediatric abdominal transplantation and transplantation research, who was the lead surgeon on Cesar's transplant.

A little more then a week after the surgeries, Dr. Khanna and his colleague, Marquis Hart, M.D., UCSD Healthcare director of abdominal transplantation surgery and lead surgeon on Turner's transplant, introduced their two patients and their families. Feeling a kindred bond, Turner and his wife Shirley presented the little boy with a stuffed animal. "We definitely feel a connection with Cesar," Shirley said. "We have been just as worried about him as we have been for ourselves."

Splitting livers involves dividing a liver into two transplantable segments. A child is transplanted with the left lateral lobe, the smallest of the liver’s three lobes which makes up about 10 to 15 percent of the liver. The larger segment is transplanted into the adult.

As the region's first split-liver transplant, this landmark procedure has proven even more remarkable. "Normally, a pediatric liver transplant patient is not ready for discharge for at least two weeks, but Cesar is doing extremely well and his mother is quite adept at administering his medications, which is key to a transplant patient's recovery," said Dr. Khanna, who brought the expertise of split-liver transplant to UCSD from the University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh.

Even without the full liver, Turner is doing better then he expected, according to both his doctors and his wife. Turner, a resident of Escondido who had been waiting for a liver transplant for about a year and a half, was suffering from hepatitis C which evolved into pulmonary hepato syndrome, a complication of liver disease which affects oxygenation of the lungs.

"We had no qualms about Harold getting only a portion of the liver as opposed to the whole thing," Shirley said. "We had incredible faith in this great team at UCSD and we know that split-liver transplants have worked successfully for other people."

"Besides, there was no way we would not have shared this liver with Cesar," Shirley adds. "We could not look at his sweet face and say no. Harold doesn't need all of it to survive and Cesar only needs a little of it, and now they have both gotten a second chance at life from one organ."

There are many other children out there like Cesar who are waiting for livers; some don’t make it. Adults receive most of the organs, unless the livers are too small to work in adults. According to Dr. Khanna, there were 1,626 pediatric patients (aged 1 month to 17 years) on the United Network of Organ Sharing waiting list for liver transplantation in 1997. On average, 75 children die each year waiting for a liver.

"By dividing a healthy liver into two parts, the number of liver transplants performed could double," said Hart. "We anticipate that this procedure will help address the organ shortage. We can continue to give adults the hope that comes from a transplant and offer the same hope to many more children."