A charity worker who was told he had just months to live is now on the road to recovery after becoming the first patient in the world to receive a transplant liver as part of a groundbreaking new clinical trial.
Adam's story is featured on BBC London News (31 October, 1.30pm and 6.30pm) and includes an interview with Professor Joerg-Matthias Pollok, who co-led the trial at the Royal Free Hospital (RFH).
Adam Eisenberg’s wife Tertia praised staff at the RFH and said it was “an extraordinary miracle” that her husband was now recuperating at home after receiving a new liver in the summer as part of the DeFat study, a multicentre blinded randomised clinical trial.
The DeFat study is a NIHR funded clinical trial, led by Professor Peter Friend, Mr Simon Knight and Mr Hussain Abbas at the University of Oxford in collaboration with the NHSBT Clinical Trials Unit. The study aims to understand whether fatty livers from an organ donor can be treated to remove the fat and thus make them suitable for transplantation. It is hoped the new technique will result in more organs being available to patients who often wait years on the transplant list.
After being diagnosed 19 months ago with liver cirrhosis and non-alcoholic fatty liver disease – a condition in which excess fat leads to the development of cirrhosis – Adam was placed on a course of drugs but his health continued to deteriorate. He became too ill for a transplant and, with other treatment options fading, doctors told Adam he might only have six months to live.
But then a lifeline appeared. Adam entered a clinical trial and was given albumin infusions every 10 days. He also received advice on how to improve his health through nutrition and exercise from the specialist liver transplant assessment team, including a specialist dietician and physiotherapist.
Adam required regular drainage of fluid from his abdomen. Gradually he built up enough strength to be placed on the transplant waiting list and was then eligible to participate in the DeFat study.
Adam, who runs a music charity with his wife, said he was incredibly grateful to all the staff who looked after him and never gave up on him. “It’s thanks to them that I should hopefully see my daughter achieve her A levels,” he said. “She wants to be a music therapist, so I’d like to see how that pans out and I’d like to be an old grandfather one day.”
In the UK there are currently hundreds of people on the waiting list for a new liver but not enough donor organs available – with approximately a third of potential livers being too fatty for transplantation. It is hoped that removing fat using this technique will vastly increase the number of available livers.
Tertia, who has been married to Adam for 25 years, said: “It’s been an extraordinary miracle. To have been preparing for the worst and then to have this incredible scenario. He was so ill, so just getting him to the point where he could have the transplant was a huge achievement.”
“Throughout we’ve had absolutely amazing care and support from the staff at the Royal Free Hospital and from the team from the North London Hospice. We just feel like we’re so lucky that our daughter is still going to have a dad. We’ve had help from so many people along the way, we can’t thank them enough and of course we would like to say a special thank you to the donor and their family.”
Adam’s doctor, Professor Rajiv Jalan, said: “Adam and his wife, Tertia, displayed amazing courage and resilience. The successful outcome is testament to the extraordinary clinical care he received, the huge support he received from his family and the power of research as he was part of a clinical trial of long term albumin infusion. It also speaks volumes to how wonderful the liver is - that we were able to get it well enough for Adam to survive long enough to go on the transplant waiting list and wait for a donor organ.”
Mr David Nasralla and Professor Joerg-Matthias Pollok are leading on the DeFat trial at the RFH and were the transplanting surgeons for Adam. Professor Pollok said: “Being involved in this first in mankind procedure has been a very special moment for the transplant team.”
David added: “We are already able to offer normothermic machine perfusion which enables us to preserve the donated liver for longer and also allows us to assess the donated liver's function, giving us a better understanding of whether it is suitable for transplantation. As part of this randomised trial some of the livers will be given drugs to release fat from the liver cells, which is then removed from the perfusion machine via a special filter.
"If defatted donor livers are well tolerated this could be a game-changer for patients as this will potentially give us the ability to save more lives."