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May 22, 2001

Contact:
Nancy Lawrence
Media Relations, LHSC
519-685-8500, ext. 77642

London Health Sciences Centre achieves milestone with 1000th liver transplant

Two-year-old recipient captures hearts of hospital staff.

(LONDON, Ontario) - The staff and physicians of the Multi-Organ Transplant Program at London Health Sciences Centre are pleased to announce the successful completion of the 1000th liver transplant at the hospital. This total represents more than 25 per cent of all liver transplants done in Canada. The surgery took place in April 2001 at the Children's Hospital of Western Ontario, which is located within London Health Sciences Centre (LHSC). It was performed by Dr. Douglas Quan.

The patient is two-year-old Randi Bonokoski, from Bienfait, Sask (which is near Estevan). Randi, a vivacious and charming toddler, is the daughter of Jamie and Roxanne Bonokoski. Randi was born with Biliary Atresia which is a condition that effects 1 in 10,000 newborns. It causes the obstruction of the biliary tract in the liver and leads to cirrhosis and liver failure. Children with this disease usually become jaundiced, do not grow well and are prone to life-threatening bleeding and coma. Most children with this disorder require a liver transplant within the first two years of life, although some are older before they become gravely ill. It is not known why this condition develops, but it is not related to the mother's health, pre-natal care, or lifestyle.

The 1000th liver transplant was, in fact, the second transplant for Randi. She received her first transplant when she was eight months old.

"When Randi had her first liver transplant she was very small and, unfortunately, her hepatic artery blocked within the first few days after surgery. The hepatic artery provides the main blood supply to the liver, but in babies this blood vessel is very narrow and prone to obstruction," says Dr. Paul Atkison, Director of the Paediatric Transplant Program.

"Two attempts were made to fix the artery, but it remained blocked. Fortunately, Randi recovered from her first transplant fairly well and was able to go home within a few weeks."

The transplant team and Randi's parents were aware that the reduction in blood flow to her liver would probably cause problems with the bile flow and that she would eventually need a second transplant.

Randi was well cared for by her parents and Dr. A. Essalah in Saskatchewan until her biliary tract problems became serious and she was retransplanted in April 2001.

On a national level, liver transplants are performed in the following places: Halifax, Montreal, Toronto, Edmonton and Vancouver. Last year, a total of 408 livers were transplanted in Canada, 65 of which were done in London. LHSC did its first liver transplant in May 1977. Included in the 1000 transplants to date are 970 from cadaver donors and 17 from live donors. The total also includes combination transplants such as liver/bowel. To date, LHSC has performed 13 such cases, the first of which was done in 1989. The total number of paediatric transplants - defined as newborn to 16 - is 161 of the 1000 procedures performed.

Success rates for liver transplant are impressive with a survival rate of more than 93 per cent after one year and more than 70 per cent after five years.

"The first 1000 liver transplants at this centre represent a huge amount of work by nurses, doctors and healthcare workers, all of whom deserve credit for their contributions. Most importantly, not a single one of these transplants could have been performed without the organ donors. This milestone is a tribute to every one of those donors," says Dr. Bill Wall, Chief of the Multi Organ Transplant Program, LHSC.