RETURNS THU JAN 19 8|7c

Partial Liver Donation

By Meg Marinis, Director of Research | Oct 8th, 2009

Tainted Obligation

Thatcher's back.

And, he needs a new liver.

After Susan died at the end of Season 3, we really began to see more of Thatcher's problem with alcohol. But after Lexie moved out of his house, Thatcher pulled himself together and enrolled in a twelve-step program, where he sought help for his addiction. However, due to having a serious problem for an extensive amount of time, Thatcher's liver can no longer function under the weight of such damage.

Here in Episode 604, Tainted Obligation, Lexie brings Thatcher into the hospital. His neighbors called her when they noticed he had not picked up his mail in some time. And now at the ER, along with appearing very disoriented, he has started to vomit blood. All over Meredith's shoes. The doctors work him up, soon giving him a tragic diagnosis of end stage liver failure. Due to cirrhosis, Thatcher needs a liver transplant. And soon.

Lucky for him, Meredith loves Lexie. Who loves Thatcher.

Why do people need liver transplants?

With adults, the most common causes are chronic active hepatitis and cirrhosis (which, has many causes in itself, but in Thatcher's case—alcohol abuse). With children and younger adults, the most common cause of liver transplantation is biliary atresia—a condition when the bile duct does not form properly.

How can someone only donate a part of their liver?

Meredith is considered a living donor. Living liver donors may donate one of their two lobes (around half of the liver). Then, after approximately six to eight weeks, the liver cells in the remaining lobe will grow, regenerating the entire liver back to its original size.

They select which lobe to donate, usually depending on the results of the donor's preoperative testing. However, general rules imply that if the donor plans to donate to an adult larger in size, they donate their right lobe (Thatcher exceeds Meredith in size, therefore he will be receiving her right lobe).

How come Thatcher wasn't on a transplant list again?

Depending on the transplant center, there may be rules in which the program requires patients with cirrhosis from alcohol abuse to have completed a certain time period of sobriety. These time periods may range from six months up to a year. And remember, not all centers maintain a set of rules, but Seattle Grace asks for one year of sobriety before agreeing to put them on the list.

How do you know if you are a match? What tests are required?

They will draw blood to determine that the blood type and tissue type are compatible with the recipient. However, the blood type remains more important than the tissue because anti-rejection drugs have reached such an improved status in recent years.

Once doctors have determined the match, they will want to test the general health of the donor. For example, they want to rule out any diseases such as diabetes, hepatitis, HIV, or cancers. They want to see if any prior liver surgery has been performed. They will want to know if the donor drinks a high amount of alcohol. They want to assure that the donor has no history of deep vein thrombosis or bleeding disorders (which was why Lexie's sister Molly could not donate). And they will also want to complete a psychiatric evaluation to make sure the donor understands their decision.

And obviously, they will want to check the health of the liver by performing a CT scan.

Is it safe?

Of course! Due to the improvements in surgical techniques, the risk of death for a living liver donor has decreased all the way to about a 1% chance. As with all surgery, risks do exist such as pain, infection, allergic reactions to the anesthesia, blood clotting, pneumonia, injury to the bile duct or other internal organs, and... death (though it is rare, it can happen with any surgery).

Most donors spend five to seven days at the hospital, following surgery. Once discharged, they will be on pain medication for a short amount of time, but they should expect four to six weeks of recovery and approximately three to four post-operative visits with the doctor where they will also have lab work checked as well for monitoring purposes.

For more information, please visit:

http://www.organdonor.gov/donation/typesofdonation.htm#a1

And fans, how do you feel about Meredith donating her liver to her father? Do ya'll think Thatcher deserved it? Thanks for reading!

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