Mayo Clinic completes its first paired liver donation for transplantation

Anne Werpy had been waiting a year for a liver transplant — getting sicker and more exhausted the entire time — when she was rescued by an unusual exchange that had never happened before in Minnesota.

An Eagan doctor wanted to make a living liver donation at the time Werpy needed one, but he wasn’t a good match for her. He was, however, a match for another transplant recipient, and that woman had a son. And the son’s liver was just the right size and blood type to transplant to Werpy and treat her worsening liver disease.

“I don’t know them at all,” Werpy, 52, said of the two donors. “I’m just so thankful and grateful. It’s basically a second chance at life for me.”

The chain of events was the first example in Minnesota, and at Mayo Clinic, of a paired living liver donation. The two women with liver disease both received transplants in August, and their health has subsequently improved while their altruistic donors have returned to full strength after donating portions of their livers. Mayo announced the successful paired donation on Tuesday in the hopes of inspiring more donations.

“Deceased donation is the main source of liver transplants in this country. That’s not going to change,” said Dr. Timucin Taner, the chairman of transplant surgery at Mayo who performed both surgeries to obtain the donor livers. “But hopefully we will be doing more living donors and paired exchanges as we go.”

More than 140 people are registered in Minnesota for transplants to replace failing or damaged livers, and half of them have been waiting for six months or longer, according to data from the Organ Procurement and Transplantation Network. Nine people died last year before they could receive transplants in the state, either at Mayo or the University of Minnesota Medical Center.

Living organ donations are possible when people give one of their two kidneys for transplants, or segments of their liver — the organ that filters the blood in the body and plays a key role in digestion and metabolism. Donors can give as much as 70% of their livers, which will then grow back to normal size in weeks.

“The liver is the only organ that can do that,” Taner said.

Paired donations have helped for two decades to reduce waiting times for kidneys, which remain viable for transplants as long as 24 hours after they are taken from donors. Transplant centers put their patients on registries that enable them to find paired matches with patients in other parts of the country.

In comparison, options are more limited for livers, which typically need to be transplanted within 12 hours. Most hospitals have only created pairings for liver transplants among their local patients, though the United Network for Organ Sharing is testing a collaboration across 15 U.S. transplant centers.

Mayo had protocols in place for two years before an opportunity for a paired liver donation emerged.

Typical pairings swap livers between two people who can’t give their organs to loved ones in need of transplants. Mayo’s first case, by comparison, was unusual, starting with Dr. Michael Broeker of Eagan, who had already donated a kidney in 2022 and wanted to donate his liver to anyone who needed it.

Broeker, 53, was thrilled to learn his decision produced two transplants: “I feel I have been blessed with really good health, and I see people who aren’t so fortunate.” His gradual recovery this fall allowed the family practice doctor to return to running and plan a half-marathon training run this weekend in preparation for a marathon next spring.

“I’m no faster than I was before,” he quipped, “but not that much slower.”

Broeker’s liver donation was to a woman that Mayo didn’t identify for this story. The Rochester-based health system in a statement wrote she is “doing well” along with her son, who completed the pairing by agreeing to donate a portion of his liver to Werpy.

Paired transplant surgeries usually happen around the same time, in part to reduce the likelihood of a later donor backing out, Taner said.

“Not that that happens regularly,” he said, “but still that is one of the main reasons for doing them in close proximity.”

National guidelines prohibit transplant centers from coercing anyone to participate in a pairing or to delay a transplant to make the timing of a pairing work. Financial incentives are also prohibited. Transplant centers are also asked to keep pairings anonymous during transplants so that one side doesn’t put pressure on the other.

“I don’t know whose liver I have,” Werpy said, but she knows the donation by the unidentified man has made a difference. The fatigue, jaundice and itchiness are gone. The Brookings, S.D., woman is walking, spending time with friends and relatives, and winning her family’s annual fantasy football league. One of her sons is getting married next year, and she is planning for the wedding.

She hoped her story would inspire more people to sign up to be organ donors.