The UAB Division of Transplantation recently performed a split-liver transplantation – marking the first use of this life-saving procedure at UAB and Children’s of Alabama (COA) in almost a decade.
The operation involves a complex interplay, timing the donor operation and two potential recipients, in separate hospitals, who benefit by receiving a part of a whole liver from a deceased donor.
The transplantation was led by UAB Assistant Professors of Surgery Saulat Sheikh, M.B.B.S., and Marcos Pozo Jatem, M.D. This innovative method requires several supporting factors, including machine perfusion technology, to increase the longevity of the donor liver outside the human body, along with a multidisciplinary team of medical, nursing, and administrative professionals that are involved in coordinating the donor operation, usually out of state, and two recipients at both UAB and COA.
“This represents the culmination of extensive preparation, education, and protocol creation alongside multiple teams,” says Dr. Pozo Jatem, Surgical Director of the Pediatric Liver Transplant Program, “including PICU, hepatology, anesthesiology, pharmacy, nutrition, nephrology, and interventional radiology, among others. It even resulted in the creation of a new intraoperative dialysis protocol (CRRT, continuous renal replacement therapy) to allow us to perform this delicate operation even in critically ill patients that require fine tuning of their volume status during the operation.”
“There are several individuals who should be highlighted for their integral contributions to making this transplantation possible – without them this day would not have been possible, and two lives would not have been changed forever,” says Dr. Pozo. Among those who contributed to the success of this transplant were Meloneysa Hubbard, MSN, CRNP, CCTC, who was responsible for securing the availability of machine normothermic perfusion; as well as patient care coordinators Robin Greer, MSN, CPNP, and Julia Roberson, CRNP; and newly named transplant surgery operating room team leader Shannetta Simon, RN.
Countless other nurses and physicians from across UAB-Children’s partnership for multidisciplinary patient care were crucial to this procedure, including: Assistant Professor of Pediatrics David Willcutts, M.D., Associate Professor of the Pediatric Intensive Care Unit Jeremy Loberger, M.D., and Professor of Nephrology David Askenazi, M.D., MSPH.
“The availability of the machine perfusion technology is an important step to be able to procure organs from elsewhere in the U.S. without increasing the amount of time the liver is in cold storage, which can reduce its usability — by maintaining continuous blood flow through the donated liver,” says Pozo Jatem.
According to Dr. Sheikh, who is also spearheading the Living Donor Liver Transplant program at UAB as its Surgical Director: “This successful split-liver transplantation represents an important achievement and a step toward a future than can impact many more patients on our waitlist. It's an intensive endeavor with the potential to greatly benefit both of our liver transplant programs across Alabama, and we couldn’t do it without the dedication and support of our fantastic co-institutional teams.”
This major accomplishment comes just a few short months after UAB successfully reached a record of seven transplantations in one day – with four concurrent liver transplants, along with three kidney transplants on Wednesday, April 16, 2025.
“These major milestones build upon the legacy of a program that has long been dedicated to serving at the forefront of care and transplantation technology in the Southeast and beyond,” says Fay Fletcher Kerner Endowed Chair of Surgery Herbert Chen, M.D.
About the UAB Division of Transplantation, Comprehensive Transplant Institute
The UAB Division of Transplantation offers a comprehensive pediatric and adult liver transplant program staffed with multiple organ transplant coordinators and support personnel who ensure that patients receive thorough follow-up care at every stage of the process.
Since 1968, UAB's transplant services have performed more than 17,000 organ transplants with more than 400 organs each year, which ranks the program among the nation's leaders in the number of transplants performed and patient outcomes.
The UAB Division of Transplantation and Comprehensive Transplant Institute are comprised of board-certified and fellowship-trained surgeons committed to providing patients with comprehensive, compassionate care throughout the transplant process.