With great interest, we read the article by Kumar et al1 entitled “Establishment of Solid Organ Transplantation in the United Arab Emirates”.
We applaud the work of the team who performed their first living donor liver transplant in the United Arab Emirates (UAE) in 2018 at Cleveland Clinic, Abu Dhabi. We understand well the difficulties of commencing and sustaining such programs from our own experiences.
One of the limiting factors for liver transplantation in the UAE over the past 30 years or so, as in much of the Middle East and Asia, has been the lack of organ availability from deceased donors. Without the donor availability and with relatively small national population sizes, there was limited motivation for establishing transplant programs with the attendant need to maintain skilled surgical, medical, intensive care, and nursing teams. Patients in need of liver transplantation living in the Middle Eastern have tended thus to seek help in Europe, the United States, and Asian countries.
Increasing interest in living liver donors has been one solution, and for that reason, our program, based in Amman, Jordan, became increasingly engaged in developing living donor liver transplantation across the Middle East. In early 2007, the medical authorities in the UAE approached us to establish a medical team to visit the UAE regularly and provide our expertise in collaboration with a supporting team from Zayed Military Hospital, Abu Dhabi.
In August 2007, our first case was a 46-year-old male patient with acute-on-chronic liver failure secondary to cryptogenic cirrhosis.2 His wife donated her right lobe after an extensive preoperative workup, which included a liver biopsy that revealed a fatty infiltration of <10% and only after the psychiatric team and local ethical committee approved the donation. The first successful living donor liver transplant in the UAE thus took place on August 10, 2007, and involved transplantation of the right liver lobe with a single right hepatic artery, a single portal vein, a single hepatic vein, and a single bile duct. The transplantation surgery was uneventful and both the recipient and donor were discharged well. We are pleased to report that this year marks the 13th anniversary of this transplant in the UAE. The recipient remains very well, attending regular follow-up visits and continuing to return normal laboratory findings.
We are delighted to see the renewed efforts at Cleveland Clinic, Abu Dhabi, to develop and sustain a living donor liver program in the UAE. Our initial procedures provided proof of the concept for such a program, and we recognize that it has taken the efforts of many to emulate that first procedure and convert it into a sustained local program for the enduring benefit of the citizens of the UAE.
1. Kumar S, Sankari BR, Miller CM, et al. Establishment of solid organ transplantation in the United Arab Emirates. Transplantation. 2020;104:659–663.
2. Khalaf H, Marwan I, Al-Sebayel M, et al. Status of liver transplantation in the Arab world. Transplantation. 2014;97:722–724.