1 00:00:00,200 --> 00:00:03,500 Most people don't want to spending time in a hospital, 2 00:00:03,540 --> 00:00:07,480 of course you will say, but perhaps you don't study medicine like me and you don't have a doctor 3 00:00:07,480 --> 00:00:11,420 retired as an uncle. He knows everyone and decided to help me choose the 4 00:00:11,420 --> 00:00:15,440 specialization. It's not a pill morphine. It doesn't let everyone through 5 00:00:15,440 --> 00:00:18,520 set of the greatest show on television doctor of the history of surgery and 6 00:00:18,520 --> 00:00:21,820 advanced research, although practice my uncle's hospital is definitely 7 00:00:21,820 --> 00:00:22,820 experimental. 8 00:00:23,500 --> 00:00:26,380 Robert is charming, come down again more. 9 00:00:26,760 --> 00:00:29,360 It's really too late to sign up for the jurisprudence? 10 00:00:40,240 --> 00:00:44,720 The liver is very important. An organ I believe it performs multiple functions 11 00:00:44,720 --> 00:00:48,620 more or less a hundred. It's not interesting to the media, it's not sexy. A 12 00:00:48,620 --> 00:00:52,760 but from the heart yes. If your liver it doesn't work, the brain doesn't work, 13 00:00:52,800 --> 00:00:54,940 the heart doesn't work, the kidneys. 14 00:00:55,280 --> 00:00:57,780 It should be at the top of the list vital organs of the body. 15 00:00:58,000 --> 00:01:01,580 From a surgical point of view it is the perfect organ. For the liver, hooray! 16 00:01:06,940 --> 00:01:08,760 Today we will deal with hepatology. 17 00:01:09,370 --> 00:01:13,630 The study of liver diseases. With lots of super passes to follow the 18 00:01:13,630 --> 00:01:16,230 procedure and attend a live event liver transplant. 19 00:01:18,270 --> 00:01:22,050 As usual we started with some communication problems. 20 00:01:22,530 --> 00:01:26,570 I've worked in all departments of this hospital, but you had a meal 21 00:01:26,570 --> 00:01:30,590 decent. But now I'll take care of it nephew to bring me something good from 22 00:01:30,590 --> 00:01:34,450 out. You know what? Maybe a dessert? A really nice sandwich. 23 00:01:35,650 --> 00:01:37,470 Ah, here it is. 24 00:01:38,240 --> 00:01:41,820 Then it's done. There was one on the West Coast, they're bringing it 25 00:01:41,820 --> 00:01:45,660 with a plane. A plane? Yes, it already is packaged in a special 26 00:01:45,660 --> 00:01:49,880 the ice. This way it stays beautiful fresh. Of course, and there is a team ready 27 00:01:49,880 --> 00:01:53,800 rush him here. But this wasn't it necessary. However, now all that remains is 28 00:01:53,800 --> 00:01:55,740 wait, the liver is coming. 29 00:01:56,640 --> 00:01:57,640 Liver? 30 00:01:58,060 --> 00:01:59,200 I had asked Rosby. 31 00:02:01,780 --> 00:02:06,560 The liver is the most robust organ of the body and is also quite heavy, 32 00:02:06,560 --> 00:02:07,560 the three kilos. 33 00:02:09,009 --> 00:02:12,670 It looks a little like this ball from football, albeit in a different form. It is 34 00:02:12,670 --> 00:02:16,590 located in the upper part of the 'abdomen, on the right side, then goes down 35 00:02:16,590 --> 00:02:21,070 waist. If I had to compare it to one machine or equipment, I would say it is 36 00:02:21,070 --> 00:02:24,350 together an energy plant and a purification plant. 37 00:02:25,130 --> 00:02:27,590 The liver is a kind of multiservice. 38 00:02:28,170 --> 00:02:32,750 Filters stories, produces hormones and above all it helps to transform food 39 00:02:32,750 --> 00:02:33,750 digested into energy. 40 00:02:34,920 --> 00:02:38,380 Breaks the molecular chain of proteins from the intestine 41 00:02:38,380 --> 00:02:41,500 through the portal vein and transforms them into glucose. 42 00:02:42,040 --> 00:02:46,160 Glucose is released into the blood through the hepatic vein, which flows into it 43 00:02:46,160 --> 00:02:50,360 heart. So if your liver has problems managing the chain 44 00:02:50,600 --> 00:02:52,480 the whole body will be affected. 45 00:02:54,880 --> 00:02:59,640 Usually the most common symptom is l 'fatigue. I had no energy and 46 00:02:59,640 --> 00:03:00,640 it was a bad flu. 47 00:03:00,960 --> 00:03:03,880 It was like having something very bad cold, but amplified. 48 00:03:04,300 --> 00:03:05,720 I almost couldn't walk. 49 00:03:06,200 --> 00:03:10,500 Yellowish eyes and color are also They are a symptom of liver problems. Yes 50 00:03:10,500 --> 00:03:11,620 called jaundice. 51 00:03:12,000 --> 00:03:16,220 It's an obvious symptom. It's not like when you are tanned. And beyond the famous 52 00:03:16,220 --> 00:03:19,200 yellowish color there are also very dark urine. 53 00:03:19,480 --> 00:03:22,580 These symptoms are due to excess of bilirubin. 54 00:03:22,920 --> 00:03:23,920 Bilirubin. 55 00:03:24,180 --> 00:03:25,760 Oh, it's a band? 56 00:03:26,580 --> 00:03:30,040 It is also a pigment produced when the old blood cells come 57 00:03:30,040 --> 00:03:31,040 eliminated by the liver. 58 00:03:32,970 --> 00:03:37,950 If the liver works slowly, not is able to adequately dispose of the 59 00:03:37,950 --> 00:03:41,610 bilirubin pigment which therefore yes accumulates in the body. 60 00:03:42,370 --> 00:03:47,450 It is yellow, so the eyes and skin are colored yellow. Not all symptoms are 61 00:03:47,450 --> 00:03:50,910 so clear and immediate. For this blood tests are needed. 62 00:03:52,190 --> 00:03:55,910 When a patient comes to ours clinic, the first thing we do to him 63 00:03:55,910 --> 00:03:59,090 to do is a blood test to see the functioning of your liver. 64 00:03:59,500 --> 00:04:02,960 The results will tell us whether the liver properly filters waste and toxins 65 00:04:02,960 --> 00:04:03,960 or not. 66 00:04:05,080 --> 00:04:09,280 If they say that the liver is not at its best and you continue to neglect it, then 67 00:04:09,280 --> 00:04:12,160 he will get sick. This disease is called cirrhosis. 68 00:04:12,960 --> 00:04:17,700 This on the left is a healthy liver, this a cirrhotic liver full of 69 00:04:17,700 --> 00:04:18,959 scars and asthenity. 70 00:04:19,320 --> 00:04:23,520 These scars are an indication of damage affecting the liver, caused by viruses 71 00:04:23,520 --> 00:04:26,580 such as hepatitis or syndrome fatty liver. 72 00:04:26,920 --> 00:04:31,000 And of course, scar tissue doesn't work as well as a 73 00:04:31,000 --> 00:04:35,120 healthy and intact tissue. That's how it comes damaged the functionality because 74 00:04:35,120 --> 00:04:39,580 serious complications can arise when blood flows through the 75 00:04:39,580 --> 00:04:44,560 liver. Every drop of blood passes through the liver every two minutes. If 76 00:04:44,560 --> 00:04:48,900 blood has difficulty flowing into the liver because flow is impeded 77 00:04:48,900 --> 00:04:51,880 scar tissue, try to find other steps. 78 00:04:53,260 --> 00:04:57,860 Blood accumulates and causes portal vein hypertension, with 79 00:04:57,860 --> 00:05:01,120 formation of new canquigni vessels in the stomach and exomagus. 80 00:05:01,400 --> 00:05:04,460 By increasing the pressure the vessels can burst and bleed. 81 00:05:04,680 --> 00:05:09,080 And this is just one of the complications of cirrhosis. When you reach it 82 00:05:09,080 --> 00:05:11,360 at this stage insufficiency begins hepatic. 83 00:05:11,700 --> 00:05:14,080 Liver failure can lead to coma. 84 00:05:14,560 --> 00:05:18,100 because the liver is not capable of purify the body of toxins e 85 00:05:18,100 --> 00:05:22,980 drugs. But don't be scared, it's not It's easy to get to these levels. The 86 00:05:22,980 --> 00:05:26,120 he must have lost 75% of his healthy cells. 87 00:05:27,060 --> 00:05:29,800 It is the only organ capable of self-regenerate. 88 00:05:30,480 --> 00:05:32,560 And we respect him too little. 89 00:05:33,320 --> 00:05:38,860 Even with 70% of the liver destroyed, functionality is ensured by 30%. 90 00:05:39,480 --> 00:05:44,620 I really had no idea I had one liver problem until I had 91 00:05:44,620 --> 00:05:45,620 collapse at work. 92 00:05:45,820 --> 00:05:50,900 I had a biopsy and this is how I have diagnosed an illness to 93 00:05:50,900 --> 00:05:56,200 liver. This is the needle we use for the biopsy. With this we arrive at 94 00:05:56,200 --> 00:05:57,200 patient's liver. 95 00:05:57,480 --> 00:06:01,440 It has the diameter like the tip of a pencil, but it's not the circumference that 96 00:06:01,580 --> 00:06:05,640 but the length. It must penetrate skin, muscles and bones to reach the 97 00:06:06,900 --> 00:06:11,780 It goes through the ribs, slips in in the muscle fascia, then we ask the 98 00:06:11,780 --> 00:06:16,320 patient to hold his breath and... It only takes a second to be 99 00:06:16,540 --> 00:06:19,740 Now we have a sample and we can study liver tissue. 100 00:06:21,160 --> 00:06:25,460 Soon we'll talk about viruses they attack the liver. Actually, one. 101 00:06:25,880 --> 00:06:27,560 Actually, not one, but three. 102 00:06:33,070 --> 00:06:36,450 Finally the liver offered by a west coast donor stood 103 00:06:36,450 --> 00:06:38,090 arrive. I didn't think about anything else. 104 00:06:38,450 --> 00:06:39,590 By plane? 105 00:06:39,790 --> 00:06:43,890 Yes, it is already packaged in a special container with ice. Uncle not 106 00:06:43,890 --> 00:06:45,370 he was thinking about nothing but the sandwich. 107 00:06:45,730 --> 00:06:47,110 I had asked for Rosby. 108 00:06:49,390 --> 00:06:53,830 One of the serious liver diseases is l hepatitis, caused by a virus that 109 00:06:53,830 --> 00:06:58,450 the liver. Symptoms of hepatitis include inflammation of the liver, 110 00:06:58,470 --> 00:06:59,910 jaundice, fatigue. 111 00:07:00,330 --> 00:07:02,530 And there is no real cure. 112 00:07:03,310 --> 00:07:07,650 I have the impression that I have contracted it 'hepatitis A when I went to the 113 00:07:07,650 --> 00:07:11,010 Dominican Republic more or less six weeks ago. 114 00:07:11,610 --> 00:07:14,690 Tropical paradises are paradises too for viruses. 115 00:07:15,270 --> 00:07:20,370 You can get sick from water, contaminated or uncontaminated ice or food 116 00:07:20,370 --> 00:07:26,060 account. I was in a hotel, I don't know if it was 4 o'clock 5 stars, I could see that they were filtering there 117 00:07:26,060 --> 00:07:30,300 'water and everything else, or give that a minimal contaminated water remained 118 00:07:30,300 --> 00:07:34,820 in the vegetables I ate, I don't know. The holiday is ruined, but there 119 00:07:34,820 --> 00:07:38,940 fatigue and jaundice last only 8 weeks and are checked with a 120 00:07:38,940 --> 00:07:39,940 special diet. 121 00:07:40,260 --> 00:07:42,500 Luckily there is no damage permanent. 122 00:07:43,140 --> 00:07:47,340 Hepatitis A is a childhood disease quite widespread in the world, but it is one 123 00:07:47,340 --> 00:07:51,020 a problem that is not in North America very present, so let's get to it 124 00:07:51,020 --> 00:07:53,300 adult without ever having taken it. 125 00:07:53,700 --> 00:07:55,880 And we don't have the necessary antibodies. 126 00:07:56,160 --> 00:07:59,600 This is why it is important to get vaccinated first to travel to risk areas. 127 00:08:00,480 --> 00:08:04,600 And then, if you get vaccinated, you probably won't you get two for the price of one. 128 00:08:05,140 --> 00:08:09,500 There will also be one for hepatitis B, which is a much more serious matter. 129 00:08:10,100 --> 00:08:12,320 The B doesn't go away in a couple of months. 130 00:08:12,590 --> 00:08:14,610 and can seriously damage yours liver. 131 00:08:15,230 --> 00:08:20,590 Every human being on the planet should get vaccinated against B. You can get it 132 00:08:20,590 --> 00:08:24,930 through blood or fluids bodily. It fits comfortably in the 133 00:08:24,930 --> 00:08:29,410 liver cells, massacring them without pity and even causing cancer. 134 00:08:29,690 --> 00:08:33,890 There are antiviral drugs that can help you, but you may have to 135 00:08:33,890 --> 00:08:35,230 take them for life. 136 00:08:36,230 --> 00:08:38,230 And the list is not yet complete. 137 00:08:39,049 --> 00:08:40,270 Hepatitis C is missing. 138 00:08:40,750 --> 00:08:44,890 which is transmitted through blood through infected syringes or 139 00:08:44,890 --> 00:08:50,010 safe. The virus settles in the liver and starts playing millions of times. 140 00:08:50,610 --> 00:08:54,610 As the liver tries to repair itself, scars are formed that can 141 00:08:54,610 --> 00:08:55,890 degenerate into cirrhosis. 142 00:08:56,750 --> 00:09:01,490 In the worst case, the liver suffers in silence even decades before there 143 00:09:01,490 --> 00:09:02,850 notice that something is wrong. 144 00:09:03,190 --> 00:09:05,970 Hepatitis C was discovered in 1989. 145 00:09:07,360 --> 00:09:11,200 Some have only recently learned about having contracted the virus, perhaps years 146 00:09:11,200 --> 00:09:17,560 before. The WHO called it a disease epidemic. There are currently no cures. 147 00:09:18,440 --> 00:09:23,920 The treatment of hepatitis C is a objective of absolute importance 148 00:09:23,920 --> 00:09:27,640 the number of patients they will have complications due to hepatitis 149 00:09:27,640 --> 00:09:32,760 only in the next ten years and only in North America will reach single digits 150 00:09:32,760 --> 00:09:35,820 astronomical in the order of tens of millions. 151 00:09:36,359 --> 00:09:38,580 Let's live a little life hepatoreckless. 152 00:09:47,220 --> 00:09:49,580 Have you ever dealt with hepatitis, uncle? 153 00:09:50,030 --> 00:09:54,450 In my absolutely memorable years fifty we had all suffered for 154 00:09:54,450 --> 00:09:58,890 something, the boys for them cars, girls for skirts a 155 00:09:58,890 --> 00:10:03,490 I was for European style berets. No, not hepatitis, I said hepatitis, uncle, 156 00:10:03,530 --> 00:10:08,410 hepatitis. There must have been those who suffered for the C, of course the C stood for club and i 157 00:10:08,410 --> 00:10:14,070 clubs in my day were wells of the pleasure, jazz club, poetry club. 158 00:10:14,070 --> 00:10:15,550 I was talking about liver problems. 159 00:10:15,750 --> 00:10:17,530 Ah, they came to us as. 160 00:10:18,010 --> 00:10:22,150 We couldn't control ourselves, if only had we known what we know now. 161 00:10:23,210 --> 00:10:26,770 Today we know that surpassing the two glasses of alcohol per day can 162 00:10:26,770 --> 00:10:30,430 harmful. So says the Foundation American Canadian for Liver. 163 00:10:31,830 --> 00:10:36,970 Alcohol abuse damages the liver, but the real culprit is sugar 164 00:10:36,970 --> 00:10:37,990 contained in alcohol. 165 00:10:38,230 --> 00:10:42,870 Excess sugar leads to a accumulation of unused fuel, which 166 00:10:42,870 --> 00:10:44,630 stored in the form of fat. 167 00:10:46,200 --> 00:10:51,680 Some accumulate fat on the abdomen, others around the liver. The filter yes 168 00:10:51,680 --> 00:10:55,340 clogs. You can feel a sense of soreness in this area. 169 00:10:55,580 --> 00:10:59,740 That's your liver telling you I'm clogged and bloated from excess 170 00:10:59,740 --> 00:11:04,180 alcohol. Conditions improve in six weeks as long as they are not taken 171 00:11:04,180 --> 00:11:08,480 alcohol. But if you go back to dating bar too often you will expose yourself to 172 00:11:08,480 --> 00:11:09,700 of long-term problems. 173 00:11:10,580 --> 00:11:13,540 Can a little tequila kill me? Ai darling! 174 00:11:14,320 --> 00:11:17,260 These are liver cells covered with fat bubbles. 175 00:11:17,660 --> 00:11:22,780 It is the so-called liver syndrome fat. The liver cannot process 176 00:11:22,780 --> 00:11:25,140 alcohol nor overeating. 177 00:11:26,200 --> 00:11:29,940 Fatty liver syndrome strikes those who suffer from high blood pressure, 178 00:11:30,120 --> 00:11:32,000 cholesterol, diabetes and obesity. 179 00:11:32,260 --> 00:11:33,900 It's a very serious thing. 180 00:11:34,260 --> 00:11:39,620 Fatty liver is the cause of 10% of liver transplants operated in mine 181 00:11:39,620 --> 00:11:42,240 center. One in ten doesn't seem like much. 182 00:11:42,890 --> 00:11:46,470 But doctors have predicted that there will be a dramatic increase in the next two 183 00:11:46,470 --> 00:11:49,070 years, because in America it is growing 'obesity. 184 00:11:49,530 --> 00:11:53,870 There is an ever-increasing number of very young people, even kids, 185 00:11:53,910 --> 00:11:59,090 suffering from fatty liver syndrome. Too much sugar damages your teeth and 186 00:11:59,090 --> 00:12:00,090 damages the liver. 187 00:12:00,290 --> 00:12:05,010 The only true therapy for the liver fat is weight loss, l 188 00:12:05,010 --> 00:12:07,170 physical and in some cases drugs. 189 00:12:09,520 --> 00:12:14,460 For patients where the damage is advanced, doctors use a special biopsy that 190 00:12:14,460 --> 00:12:16,500 highlights the real conditions of liver. 191 00:12:17,300 --> 00:12:19,540 Here, I'm getting closer to the liver. 192 00:12:21,220 --> 00:12:23,820 They stick the needle into the jugular. Yes, exactly. 193 00:12:24,080 --> 00:12:28,460 And they use it as a gateway to this very thin catheter that travels 194 00:12:28,460 --> 00:12:29,900 in your body up to the liver. 195 00:12:30,860 --> 00:12:36,200 It's called a transjugular biopsy and it is safer than normal biopsies because 196 00:12:36,200 --> 00:12:38,040 limits internal blood loss. 197 00:12:41,800 --> 00:12:46,060 A moment of absolute stillness, the doctor pushes the catheter into the liver, 198 00:12:46,140 --> 00:12:49,440 remove the sample and bring back the catheter in the jugular. 199 00:12:49,680 --> 00:12:55,060 You don't breathe, you don't breathe, you'll feel a pang, you can breathe, done, it's not like that 200 00:12:55,060 --> 00:12:57,840 terrible. Given the small engraving I would say no. 201 00:12:59,020 --> 00:13:03,760 Liver biopsy carries a risk of hemorrhage. Today's patient, who 202 00:13:03,760 --> 00:13:07,780 due to liver problems coagulation, if it bleeds, it bleeds 203 00:13:07,780 --> 00:13:11,960 vein, inside a vessel where the blood it flows anyway. That's why the 204 00:13:11,960 --> 00:13:13,280 safer. Everything is fine? 205 00:13:13,720 --> 00:13:14,920 It doesn't hurt, right? 206 00:13:15,480 --> 00:13:16,480 Important question. 207 00:13:16,740 --> 00:13:19,340 How many hepatologists do you need to do one biopsy? 208 00:13:21,200 --> 00:13:26,740 answer 10 one to run it and the others to give an opinion on this 209 00:13:26,740 --> 00:13:30,940 10-head microscope is an example of how hepatologists work as a team 210 00:13:30,940 --> 00:13:36,860 they're all looking the same sample at the same time this is 211 00:13:36,860 --> 00:13:43,520 example of scratch liver one of them, the regitta, describes the sample 212 00:13:43,520 --> 00:13:45,120 and the others analyze it 213 00:13:45,850 --> 00:13:51,530 And therefore the state of oats. Sessions of this kind allow us to see 214 00:13:51,530 --> 00:13:56,790 the real state of the cells of the patient who needs therapy or a 215 00:13:56,790 --> 00:13:57,790 diagnosis. 216 00:13:58,090 --> 00:14:02,710 There are never too many chefs in the kitchen of a hepatologist. They consult each other 217 00:14:02,710 --> 00:14:06,370 with other specialists such as surgeons to decide whether the solution is the 218 00:14:06,370 --> 00:14:07,370 transplant. 219 00:14:08,360 --> 00:14:13,040 It's a picture consistent with hepatitis C, progressive worsening of cirrhosis. 220 00:14:13,040 --> 00:14:16,760 Based on this biopsy we are at the point of arrival. It is more complete as a diagnosis. 221 00:14:16,800 --> 00:14:20,180 You don't just talk to patients and browse reports. You see cells 222 00:14:20,180 --> 00:14:24,200 in real time and that takes you to a different awareness of what the 223 00:14:24,200 --> 00:14:25,260 your patient is experiencing. 224 00:14:25,520 --> 00:14:29,640 Soon we will see what happens when you are to the point of no return and yours 225 00:14:29,640 --> 00:14:30,640 liver can't take it anymore. 226 00:14:37,079 --> 00:14:40,640 As soon as my uncle realized I was talking about a liver transplant or not 227 00:14:40,640 --> 00:14:45,060 a sandwich, he immediately cheered up, even if the donor liver was not 228 00:14:45,060 --> 00:14:49,500 arrived yet. And that's what he meant be ready and wait. 229 00:14:50,400 --> 00:14:51,820 And wait. 230 00:14:55,520 --> 00:15:00,480 The liver has immense resources, but if limited by viruses, alcohol abuse and 231 00:15:00,480 --> 00:15:03,340 inflammatory factors, can stop self-regenerate. 232 00:15:04,300 --> 00:15:08,280 Repeated damage to the liver it leads to cirrhosis, which is the answer 233 00:15:08,280 --> 00:15:12,040 of the liver to a continuous attack e so far there is no alternative therapy to 234 00:15:12,040 --> 00:15:15,920 transplant. Liver transplant today has a case history of 90%. 235 00:15:15,920 --> 00:15:16,920 survival. 236 00:15:17,480 --> 00:15:20,220 Of course there is a waiting list for liver transplants. 237 00:15:20,880 --> 00:15:25,340 Indeed, in truth, the lists are four. One for each blood type. 238 00:15:25,460 --> 00:15:29,060 Group A, B, AB and 0. 239 00:15:29,640 --> 00:15:33,620 A group A patient can get the transplant quickly, even in a 240 00:15:33,620 --> 00:15:37,560 month. Sometimes it happened that there were numerous donors A and patients have 241 00:15:37,560 --> 00:15:38,920 only waited two days. 242 00:15:39,320 --> 00:15:43,100 Instead, if you are in group 0, the list d The wait is around two years on average. 243 00:15:44,100 --> 00:15:46,500 Demand far exceeds 'offer. 244 00:15:46,900 --> 00:15:50,880 In North America they have only 3,000 liver transplants per year. 245 00:15:51,720 --> 00:15:55,180 So getting on the waiting list is not never an easy step. 246 00:15:55,800 --> 00:16:00,000 On the one hand it means that the conditions clinics are serious, on the other hand the 247 00:16:00,000 --> 00:16:03,300 a donor's liver can come in any time, it depends on 248 00:16:03,300 --> 00:16:06,480 circumstances and the recipient must make himself find ready. 249 00:16:07,200 --> 00:16:11,440 They had to give me a pager then before they could find me a search 250 00:16:11,440 --> 00:16:13,380 people and they found me a liver. 251 00:16:13,940 --> 00:16:18,100 This phone call triggers a series of events which will all take place within 24 252 00:16:18,100 --> 00:16:19,100 hours. 253 00:16:20,540 --> 00:16:23,820 A team is responsible for recovering the liver from the donor. 254 00:16:24,350 --> 00:16:28,950 It is surgically removed, the donor is dead, but his liver can 255 00:16:28,950 --> 00:16:29,950 another life. 256 00:16:30,110 --> 00:16:33,750 Then the organ is placed on ice and brought to the recipient, wherever you are 257 00:16:33,750 --> 00:16:38,250 you find, who, at the same time, is prepared for surgery by a 258 00:16:38,250 --> 00:16:39,550 'another specialized team. 259 00:16:39,810 --> 00:16:43,690 It is quite common that a liver can come from the west coast, 260 00:16:43,770 --> 00:16:47,790 will cross the country, remaining in the ice all the way, it will come 261 00:16:47,790 --> 00:16:51,370 on the other side of the continent, he will come taken to an operating room and 262 00:16:51,370 --> 00:16:52,550 transplanted into a patient. 263 00:16:57,150 --> 00:17:01,410 Doctor, where does the majority come from part of the livers for transplants? From 264 00:17:01,410 --> 00:17:02,930 any place or circumstance. 265 00:17:03,150 --> 00:17:06,770 What we are waiting for comes to us from the victim of a car accident. 266 00:17:07,410 --> 00:17:08,410 Excuse me for a moment. 267 00:17:10,750 --> 00:17:15,130 What surprises me most is that the liver fights practically every day 268 00:17:15,130 --> 00:17:19,869 and we can completely ignore the the fact that he is ill and continue to... 269 00:18:02,959 --> 00:18:08,720 I told him, he's always ready Yes, Let's take the liver to the operating room 270 00:18:13,680 --> 00:18:18,400 My uncle had greased some gears and we witnessed the transplant. L 271 00:18:18,400 --> 00:18:20,120 The surgery lasted about four hours. 272 00:18:20,840 --> 00:18:22,680 Challenging, but pretty essential. 273 00:18:22,980 --> 00:18:27,160 First we make sure the liver is intact and that the venaporta that carries 274 00:18:27,160 --> 00:18:29,820 to the liver the nutrients are in good condition. 275 00:18:30,760 --> 00:18:34,780 You must disconnect and reconnect the entire distribution system 276 00:18:34,780 --> 00:18:38,880 liver. First the venaportal, which receives give you protein-rich blood 277 00:18:38,880 --> 00:18:43,260 intestines. Then the hepatic vein, which transports the purified blood to the 278 00:18:43,280 --> 00:18:47,700 And finally the hepatic artery, which acts as a fuel pump for the 279 00:18:47,720 --> 00:18:49,600 carrying oxygen-rich blood. 280 00:18:50,980 --> 00:18:52,760 It all seems to be going pretty well. 281 00:18:54,920 --> 00:18:56,900 Here it is, the liver. 282 00:19:00,170 --> 00:19:04,930 Until the mid-90s there was talk of a 50% organ rejection rate now 283 00:19:04,930 --> 00:19:09,430 we are between 10 and 15%. One thing that I've always wondered about transplants 284 00:19:09,430 --> 00:19:12,690 it's not because problems arise rejection, but how do they work. 285 00:19:12,770 --> 00:19:17,070 In short, we take a liver from the someone's body, then we put it under 286 00:19:17,070 --> 00:19:22,290 ice for more than 14 -15 hours, lo we sew inside the body of another and 287 00:19:22,290 --> 00:19:25,890 review. We will soon see that the liver it is the zombie of the body. 288 00:19:26,170 --> 00:19:29,430 He gets up and walks even if you believe that is dead. 289 00:19:34,890 --> 00:19:39,090 My uncle was distracted at the moment of liver delivery, but for 290 00:19:39,090 --> 00:19:41,650 I was present and I immediately ran to recover it. 291 00:19:42,230 --> 00:19:45,630 It was too important a thing to do catch you unprepared. 292 00:19:47,970 --> 00:19:50,790 Ah, I told him, he's always ready. 293 00:19:51,330 --> 00:19:55,310 If you think that wait the Wagons are stressful, think about it 294 00:19:55,310 --> 00:19:56,570 be waiting for a liver. 295 00:19:56,930 --> 00:20:01,350 But hepatologists offer you a 'alternative. Liver transplant from 296 00:20:01,350 --> 00:20:02,350 living relative. 297 00:20:03,560 --> 00:20:08,740 The donor is a living relative and he or they give you a part of their liver, 298 00:20:08,760 --> 00:20:12,840 but if they give a part of it to you as can they survive? The answer 299 00:20:12,840 --> 00:20:14,200 Happy Doctor Frankenstein. 300 00:20:16,419 --> 00:20:20,660 The reason why it can be done transplant from a living relative is that the 301 00:20:20,660 --> 00:20:25,320 it can self-regenerate, rather unusual for an organ. The liver is one 302 00:20:25,320 --> 00:20:29,100 of the organs, indeed it is the only organ in able to do it. The amount of time 303 00:20:29,100 --> 00:20:33,420 required for this process is variable, but already after a month, e 304 00:20:33,420 --> 00:20:37,460 in the donor, you can see that the liver has started to grow again. It takes 6 to 8 305 00:20:37,460 --> 00:20:39,860 weeks so that he can resume his resignation. 306 00:20:40,160 --> 00:20:42,700 This is what hepatologists call regeneration. 307 00:20:43,280 --> 00:20:44,720 Imagine, you cut your finger. 308 00:20:45,210 --> 00:20:46,430 and watch it grow back. 309 00:20:46,930 --> 00:20:49,870 Impossible, right? Yet the liver does does it all the time. 310 00:20:50,550 --> 00:20:54,570 You can cut half the liver and in a few weeks the other half yes 311 00:20:54,570 --> 00:20:59,050 regenerates. Doctors don't know how it can happen happen and they have been worrying about it for a long time. 312 00:20:59,190 --> 00:21:01,570 The mystery is the subject of deception research. 313 00:21:01,970 --> 00:21:05,910 If you found out how cells do it liver to regenerate you will become a 314 00:21:05,910 --> 00:21:09,990 rich. What if we found out why it works transplant from a living relative 315 00:21:09,990 --> 00:21:13,370 we could discover new treatments for viral hepatitis and cancer. 316 00:21:18,570 --> 00:21:22,410 We're going too fast for me uncle. He knows only the donation 317 00:21:22,410 --> 00:21:26,170 traditional, not the live one. Also if it is half a liver. One thing 318 00:21:26,170 --> 00:21:27,170 what do I do. 319 00:21:27,850 --> 00:21:32,630 They are alive, they are alive. Sure uncle, the liver regenerates itself. 320 00:21:32,850 --> 00:21:36,670 Oh, it heals itself, it's true, it was me slipped my mind. 321 00:21:37,330 --> 00:21:41,750 We all live from generation to generation generation and so on forever. 322 00:21:41,850 --> 00:21:46,610 Congratulations truly a noble sacrifice yours. My heartfelt best wishes to 323 00:21:46,610 --> 00:21:47,610 both. 324 00:21:48,220 --> 00:21:49,340 See you gentlemen. 325 00:21:51,760 --> 00:21:56,180 My professor said that according to i Chinese the liver is the seat of the soul and 326 00:21:56,180 --> 00:21:58,840 which thanks to this can do many things different. 327 00:21:59,260 --> 00:22:02,080 From a surgical point of view it is the perfect organ. 328 00:22:02,980 --> 00:22:07,580 It may be perfect, but it's not guaranteed let it stay there. Do not abuse with food ed 329 00:22:07,580 --> 00:22:10,820 alcohol and getting vaccinated against hepatitis helps keep it healthy. 330 00:22:11,720 --> 00:22:15,840 We wake up every day and a car drives you could invest that morning or there 331 00:22:15,840 --> 00:22:18,720 next morning and maybe you could have avoid it. 332 00:22:19,680 --> 00:22:23,840 Let's get vaccinated against hepatitis A and B. I think liver transplant me 333 00:22:23,840 --> 00:22:28,660 taught one thing. It made me understand that this life of ours is very short and 334 00:22:28,660 --> 00:22:32,240 filled with sweetness. As a child I forced to eat liver 335 00:22:32,320 --> 00:22:33,860 I'm continuing the tradition. 336 00:22:34,120 --> 00:22:36,520 I don't know if Dr. Deschain eats liver. 337 00:22:36,890 --> 00:22:40,970 It wouldn't surprise me if he ate it. In November, the day of my return 338 00:22:40,970 --> 00:22:44,650 an important meeting with the American Studies Association 339 00:22:44,650 --> 00:22:47,970 Liverworts, my wife has me for lunch cooked the liver. 340 00:22:49,110 --> 00:22:50,690 Doctor Deschamps eats everything. 341 00:22:51,170 --> 00:22:52,170 Liver! 342 00:22:52,670 --> 00:22:56,530 The liver is an amazing thing, right uncle? I prefer red.