Brandon Rice went to bed a normal 4-year-old, but woke up the next morning with yellow eyes and yellow skin. Within two weeks, the little boy lay in a hospital bed, hooked up to three dozen tubes and so bloated with fluid that he was twice his normal weight. The diagnosis: a malformed liver.
"He was a totally different kid, you wouldn't have believed it," remembers Brandon's mother, Melissa Rice. "It was awful, it didn't even look like him."
Doctors at the C.S. Mott Children's Hospital at the University of Michigan in Ann Arbor immediately added Brandon's name to the transplant list, a little life among thousands of patients with liver failure.
"His prognosis was poor; nearly 2,000 people die each year waiting — in vain — for a new liver," explains ABCNEWS' Medical Editor Dr. Timothy Johnson.
"In the intensive care unit, we have very good mechanical systems to replace the functions of the heart, the kidney, but never the liver," says Dr. Robert Bartlett, Brandon's doctor and division chief of surgical critical care. "So patients who were dying of liver failure, short of a transplant, there was nothing we could do for them."
In fact, Brandon's parents began to plan their little boy's funeral before a medical innovation made possible his recovery.
An ‘Artificial Liver’
For the more than 17,000 patients like Brandon, hope may now be on the horizon — thanks to a new and cutting-edge liver support system known as a Molecular Absorbent Recirculating System, or MARS.
This "artificial liver," developed in Germany, removes toxic substances from the blood that would normally be filtered out by a functioning liver.
The device transports a patient's blood to a filter where it is mixed with a sticky protein called albumin. The toxins in the blood attach to the albumin molecules, which then carry the poisons out of the blood, explains Dr. John Magee, assistant professor of surgery and a pediatric liver transplant surgeon at the University of Michigan.
Although still in the pioneering stages, experts agree that the albumin dialysis has tremendous potential, especially as the number of liver patients increases nationally.
"It is estimated the number of deaths from end-stage liver failure will triple in the next 10 years, says Dr. Robert F. Brown Jr., medical director of the Center for Liver Disease and Transplantation at Columbia Presbyterian Medical Center in New York City.
In addition,"25 to 50 percent of today's hepatitis C-infected patients will go on to develop some sort of permanent damage to the liver," comments Dr. George Mazariegos, an associate professor of surgery at the Starzl Transplantation Institute and co-director of the pediatric liver transplantation program at the Children's Hospital of Pittsburgh.
A Bridge, Extending Life
Soon, says Brown, demand will outgrow the supply of organs for transplantation, creating "an enormous need for novel technologies to provide artificial liver support." The albumin dialysis system buys time and opens the window of opportunity for doctors to save lives, he adds.
"If the liver can regenerate on its own, MARS provides temporary support until the liver is able [to] recover. If not, the device serves as a bridge, extending life until transplant," explains Magee.
Of the 20 patients Dr. Bartlett has treated, all have recovered from their coma, while five, including Brandon, have survived and are doing well.
"It's a good machine. It kept Brandon going for 36 hours and he'll still here," said Melissa Rice.
For Brandon, the liver support system is a miracle that he will only dimly remember, yet it is the miracle that, while he awaited his liver transplant, kept him alive.