An Introduction to Liver Transplant Compatibility

For more than 25 years, Dr. Lewis Teperman has worked as director of transplant surgery at the New York University School of Medicine. Lewis Teperman also serves as vice chair of surgery. Over the years, Dr. Lewis Teperman has helped guide patients through the many steps required for successful kidney and liver transplant operations.

Donating a liver to a person who will greatly suffer, or die, without a new liver can be a highly rewarding experience. However, the process of matching an in-need patient with a compatible donor is complex, and even a perfectly matched patient and donor can run into complications. There are a few basic steps a surgeon and his or her medical staff will perform in order to gauge the likelihood of a successful liver transplant. First and foremost, the patient and donor must share the same blood type. A donated liver can be rejected by the host body for any number of reasons, some of them unclear, though a liver with an incompatible blood type has no chance of being accepted.

A donor’s liver must, of course, be healthy enough to survive the transplant and subsequently perform the vital processes of expunging toxins from the body and preparing vitamins and nutrients for use by other organs. This means a donor must be free of liver disease as well as related issues, including hepatitis, cardiovascular disease, and pulmonary disease. A donor should also be in generally good shape, meaning they could not qualify as obese or be engaged in any substance abuse, be it alcohol, prescription medicine, or illegal narcotics.

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What to Expect After a Liver Transplant – Post Operation Care

Dr. Lewis Teperman cares for patients at the New York University Langone Medical Center who require organ transplants. The vice chair of the center’s surgery department, Dr. Lewis Teperman helps prepare patients for the liver transplant procedure – and life afterward – in order to optimize the lifespan of the new organ and ensure future health.

Patients at the Langone Medical Center require close monitoring after liver transplant surgery, which requires them to spend a few days in a hospital’s intensive care unit (ICU). During their stay, they are attached to various monitoring and fluid delivery and drainage systems, including a heart monitor, intravenous lines (IVs), and a breathing tube if required. Removal of the breathing tube occurs after patients become strong enough to breathe on their own. Due to an increased susceptibility to illness, only immediate family may visit.

Once a patient’s vitals stabilize, they move to a postoperative unit specifically for transplant patients for furthering monitoring and education on life post-surgery. Patients receive physical therapy and instructions for rehabilitation and nutrition. In addition, they become familiar with the medications they will require for the rest of their lives.

After close monitoring is no longer required, patients move to a regular hospital room to complete their recovery and post-surgery education. Prior to discharge, patients must learn about restrictions and other essential points on caring for themselves after surgery. In order to become accustomed to normal life once they leave the hospital, patients also engage in daily living activities while under the supervision of a health care team. Patients return home after their stay in the normal hospital room.

Complete patient recovery can take up to three months. Patients often find they can carry on normal lives after making a full recovery.

Living Organ Donors – A Brief Overview of Liver Donation

The liver is an organ capable of regenerating itself over time, provided no illness causing permanent damage exists. Due to these regenerative properties, transplant surgeons such as Dr. Lewis Teperman encourage eligible individuals to consider becoming living organ donors. The director of transplantation for the New York University Langone Medical Center, Dr. Lewis Teperman has conducted research concerning the increased survival rate of liver disease patients who receive a piece of a living donor’s liver.

Liver transplants occur only after the exhaustion of other medical treatments. Alongside the recipient, living organ donors undergo surgery in which a segment of the donor’s liver is removed and given to the recipient. Within a short period of time, the livers of both the donor and the recipient will return to normal size. Living donors are not required to be related to the recipient, provided they prove to be a match.

Individuals seeking to become living donors must undergo a screening process to determine whether they fit the physical and mental criteria. Factors which cause ineligibility include pregnancy, active alcohol or substance abuse, and diseases of the liver, heart, or lungs. Candidates meet with doctors, nurses, a donor advocate and social workers who assess their health and the likelihood of a successful surgical procedure; if approved, candidates can become living donors and begin preparation for the upcoming procedure, including meeting regularly with a social worker to ensure their full consent and understanding.

Living donor candidates are encouraged to become fully informed about the procedures, benefits, and risks regarding donating a segment of their liver, and to not make the decision under duress. While living donors can increase the success rate of treatment for patients with liver disease, the surgical procedure does involve risks, including blood clotting, pain, pneumonia, and deep vein thrombosis. However, these risks can be reduced by keeping the transplant team fully informed of the donor’s medical history.

Five Ways You Can Assist the American Liver Foundation

Transplant surgeon Dr. Lewis Teperman is a member of the Medical Advisory Committee for the American Liver Foundation. The director of transplantation and vice chair of surgery for the New York University Langone Medical Center, Dr. Lewis Teperman is actively involved in transplantation research and programs, as well as the treatment of liver diseases. To assist in the fight against liver disease, the American Liver Foundation offers an assortment of donation opportunities to the public. In addition to conventional online or mail-in donations, the following options are available:

1. Honor Gifts. Honor donations can be made on behalf of a friend, family member, or colleague to support participants in the Liver Life Walk and Liver Life Challenge.

2. Memorial Gifts. Memorial donations given in memory of someone who passed away due to liver disease provide support to Liver Life Challenge participants, or sponsor a participant in the Liver Life Walk.

3. Fundraising. Individuals wishing to begin their own fundraising campaign can create an event page through the American Liver Foundation. There are three fundraiser types: honorary, memorial, and special event or occasion.

4. Stock Gifts. Stock market losses can be turned into tax deductions by selling stock at a loss and donating the funds acquired to the American Liver Foundation. Charitable deductions can then be applied to the donation, and the stock’s decrease in value is deducted from taxes owed. Consultation with financial or legal advisors is suggested prior to partaking of this opportunity.

5. Used Vehicle Donations. Used vehicles can be given as tax-deductible donations through the Drive Away Liver Disease program.

In addition, those interested in going beyond a single donation can become a part of the foundation’s Legacy Society, which is comprised of donors who either have created or intend to create a planned or deferred gift. Legacy Society members can provide charitable bequests or life insurance gifts that name the American Liver Foundation as the beneficiary of a life insurance policy.

Further information for donating may be found at http://www.liverfoundation.org/howtohelp.

The American Liver Foundation – Events and Fundraising

The director of transplant surgery at NYU Langone Medical Center, Dr. Lewis Teperman has more than 30 years of experience and specializes in hepatobiliary surgery and liver transplants, including living donor transplants. Dr. Lewis Teperman is the recipient of the 2014 Physician of the Year award from the American Liver Foundation (ALF).

Founded in 1976, the American Liver Foundation was the nation’s first voluntary health agency created specifically to study and fight liver disease. Dedicated to increasing education, support, and research for liver disease, the foundation also works to increase public awareness. For more than 30 years, the ALF has provided over 800 scientists and physicians with $24 million in research funding.

The ALF holds a number of events, like the Liver Life Walk, Liver Life Challenge, and Flavors Culinary Experience, throughout the year to raise funds and support for the foundation and the more than 30 million Americans affected by liver disease. The ALF also accepts direct support in the form of donations, honor or memorial gifts, and personal fundraising efforts. To learn more, visit www.liverfoundation.org.

New Anti-HCV Therapies May Reduce Liver Transplant Demand

For more than 20 years, Dr. Lewis Teperman has worked in numerous capacities, including that of the NYU Langone Medical Center’s director of transplantation. A liver transplant expert, Dr. Lewis Teperman has also conducted research on the care of patients with liver tumors or liver disease.

According to the American Journal of Managed Care, new agents for the fight against HCV are yielding better results with shorter treatment periods. The introduction of medications like Sofosbuvir (Sovaldi) and Simeprevir (Olysio) signifies a momentous step towards managing a disease that creates an overwhelming demand for liver transplants and claims the lives of an estimated 16,000 Americans per year. Used with Ribavirin and Interferon, these medications have been shown to reduce the effects of HCV and to do so three to six months faster than previous treatments. HCV patients currently receive a third of all available liver transplants in the United States, and these breakthrough treatments can help decrease that demand.

While physicians prescribed Sofosbuvir almost 5,000 times within the first two months of its release, many early-stage patients are choosing to wait for the arrival of next-generation medications on the market. The next wave of medications will offer reduced side effects and even higher success rates in the battle against the slowly progressing viral disease.

Dr. Teperman leads a research study at NYULMC transplant which is looking at how to treat patients with alternatives to Interferon.

Dancing in Saudi Arabia

It is not every day that a Manhattan doctor, raised in the Bronx, is invited to take part in a cultural dance in Saudi Arabia. In February of this year, that’s exactly where I found myself and my teenage daughter. I was invited by His Excellency Sheik Abdul Moshin Al-Tuwaijri to speak at the National Guard Health Affairs, King Abdulaziz Medical City, King Fahad Hospital in Riyadh, Saudi Arabia. At the same time, we were able to attend the Janadriyah Festival and dance in one of its celebrations.

The Janadriyah National Heritage and Culture Festival takes place near Riyadh, Saudi Arabia. Started in 1985, the festival showcases the cultural heritage of the various regions of Saudi Arabia and neighboring Gulf countries. It allowed us to experience traditions, culture and food from different regions. It allows visitors to better understand the people and its traditions.  I’m dancing here with the celebrants and a celebrity too- Giancarlo Esposito of Breaking Bad.

It wasn’t my first trip to Saudi Arabia and I could expand on the topic of liver transplantation and what I was there to teach. The state of the art hospital and architecture and skyline are also impressive. However, it is the people that we met and the conversations that we had which were the most meaningful to me. It was also the first time I was able to share it with my teenage daughter. Many people enthusiastically welcomed us into their homes to discuss Saudi Arabian culture. Visiting and socializing in one’s home does make a difference and we found the people we met extraordinary, kind and genial.

Dare I compare our experience in Saudi Arabia to the Bronx I knew as a young boy? I have to admit that the people and close bonds of neighbors have similarities. I am so grateful that liver transplantation has allowed me to open my eyes to other cultures and parts of this world. It was a true joy to share this with my daughter. I know she will take this experience with her as she prepares for her own future, hopefully with the same open spirit.ImageImage