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.

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.

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

Living Liver Donation for Patients with Liver Cancer

On Valentine’s Day last year, I had the privilege of leading a 12-person team of surgeons, anesthesiologists, residents and nurses while a loving husband gave his wife part of his healthy liver to cure her from her liver cancer. 

Liver disease affects all walks of life and the husband, Bryan Li, was a perfect match to proceed with a lifesaving surgery for his wife, Francine Meng. Without the gift of living liver donation from her husband, Francine Meng would have spent 18 months to two years waiting for an organ.  She would have never gotten an offer and died from her cancer.  As a loving wife, sister and mother of a young child, that was a risk she did not want to take. 

Over the course of three meetings, the interdisciplinary team of social workers, independent donor advocate, and experienced transplant nurse practitioners spoke with the patient and husband about their options and they opted for living liver donation. 

Bryan Li gave his wife, Francine Meng, part of his liver- the best Valentine’s gift probably in history.  Today, both are alive and well and able to live their life with their young son.

NYU Langone has performed live liver transplants since the late 1990s and we have performed over 100 living related liver transplants.  Over eight hours in the operating room and a dozen specialists, including Associate Transplant Director, Dr. Glyn Morgan, and transplant surgeons Dr. Bruce Gelb and Dr. Aaron Winnick, are critical to the success of the surgery.

I am proud that at NYULMC Transplant.  We serve thousands of patients but our size is just right that we know each patient and their individual situation.  It is not ironic that we care for our patients in the Mary Lea Johnson Richards Organ Transplantation Center- a health facility donated by the late Martin Richards – a loving gift from husband to honor his wife, Mary Lea.  Bryan Li and Francine Meng are no different and I look forward to seeing them for years to come.

Valentines Day

Dr. Lewis Teperman: Testing for Hepatitis C Is Crucial to Avoid Fatal Liver Disease in Those Ages 45 to 64

Dr. Lewis Teperman is a renowned transplant surgeon in New York, and the author of the 2012 article “Living donation for the very ill patient with type 1 hepatorenal syndrome: Are we ready?” Among his professional circles, he is considered an authority on hepatitis C and liver transplantation.

According to federal health officials, two-thirds of individuals with hepatitis C are between the ages of 45 and 64. The testing for hepatitis C in individuals in this age bracket is crucial; due to the lack of knowledge of the disease during the 1960s and 1970s, many blood transfusions may have been contaminated. Any exchange of blood, including that which might occur in contact sports or in manicure/pedicure procedures, also carries the potential for the exchange of hepatitis C.

Treatments have considerably improved over the last few decades, indicating the possibility for a high quality of life for those diagnosed with hepatitis C. Liver transplant surgery is also an effective way to combat liver failure, so long as the disease is discovered in time.