TORONTO - A 35-year-old Toronto father gave a priceless gift on June 18 when surgeons at The Toronto Hospital and The Hospital for Sick Children removed a portion of his liver and transplant it into his 19-month old daughter. Both father and daughter are doing well.

Approximately one quarter of Linton Samuel's liver was transplanted into Tiana Adair-Samuel, who was born with biliary atresia, a blockage of the bile duct which prevents her liver from excreting bile. An earlier attempt to unblock her bile duct was unsuccessful in overcoming the problem. Without a new liver, Tiana would die of end-stage liver disease.

The surgery - termed a living related donor liver transplant - is the first such procedure undertaken jointly by doctors at The Toronto Hospital and The Hospital for Sick Children. Surgeons Paul Greig and Mark Cattral led the procedure at TTH. Dr. Riccardo Superina performed Tiana's transplant at SickKids with the assistance of Dr. Cattral. Living related donor liver transplants have been performed in other Canadian hospitals and is a common procedure in Japan. The success rate of the procedure is equal to that of conventional cadaveric transplants.

Tiana was on the liver transplant waiting list for approximately eight months without receiving the needed organ. In order to provide a liver while she was still relatively healthy, her family decided to explore the living related donor option. Following a rigorous psychological and physical assessment, the father was found to be an excellent candidate for the procedure.

The first phase of the surgery, which took about five hours, was performed at The Toronto Hospital. A portion of the father's liver, hepatic artery, bile duct and portal vein were removed. The challenge for surgeons is to maintain proper liver function in both the donor and the recipient. The liver will grow back in about six weeks. The risk of death for the donor is less than one percent.

Shortly after the section of liver was successfully removed, it was rushed to the adjacent SickKids for the second phase of the transplant. This required removal of Tiana's diseased liver and implantation of the portion of her father's healthy liver. The procedure took eight hours.

Physically, there is no difference between receiving a portion of a parent's liver or that of an unrelated donor; the treatable rejection rate is the same at about 25 percent. However, the method provides a liver before the recipient's condition begins to deteriorate, and removes him or her from the transplant waiting list. This surgery could not be done in an emergency because of the extensive work-up required.

The multi-orgran transplant program, the largest in Canada is an integrated program of the University of Toronto, The Toronto Hospital, The Hospital for Sick Children and other U of T teaching hospitals.