51-year-old had to be retransplanted after receiving a bad liver from abroad – news Norway – Overview of news from different parts of the country

The case in summary • Ole Kasper Næss (51) had to be urgently retransplanted after the surgeons at Oslo University Hospital inserted a bad liver from abroad.• The liver was stiff and full of scarring, but the surgeons had no choice but to insert it, when they had already opened Næss.• The liver had been flown in from another country that is part of a collaborative project on organ donations in the Nordics.• Section chief Morten Hagness says that there was nothing to indicate that there was anything wrong with the liver they received from abroad.• Næss has reported the case to both the Norwegian Health Authority and the Norwegian Patient Compensation Board (NPE).• Section chief Morten Hagness points out that liver retransplantations are very demanding operations, but that Norway is in a good position compared to other countries. The summary is made by an AI service from OpenAi. The content is quality assured by news’s ​​journalists before publication. – Towards the end of last year, I received a phone call from the hospital. They called and said they had received a nice liver, and asked me to come as soon as I could, says Ole Kasper Næss. The 51-year-old has a liver disease called PSC and underwent a liver transplant for the first time in 2012. Ole Kasper thus knew what he was doing, and at 2:30 p.m. he got into a taxi and drove from Løken in Aurskog Høland to the hospital in Oslo. – I was a bit scared, but at the same time I was a bit happy. Now I was finally going to get a new liver. I was looking forward to getting back into shape. And I felt enormous gratitude for the fact that skilled surgeons were ready to receive me and give me a new and better life, he says. At the time, Ole Kasper did not perceive the situation as urgent, but what bothered him most was an intense itch, which is common with liver failure. – I remember being wheeled out of the room I was lying in, and the next thing I remember is waking up in the intensive care unit with a feeling that something has gone seriously wrong here. I felt battered and could barely move my arms or legs, he says. Stiff and full of scars Ole Kasper had then been in an artificial coma for five days. – One of the surgeons told me that something had happened that shouldn’t happen, says Ole Kasper. What was not supposed to happen was that the liver that was put in was bad. As a result, he had to be retransplanted – that is, the liver had to be taken out again, before they inserted a new one. The 51-year-old, who works daily as a farmer in Aurskog Høland, was lying with his stomach open on the operating table in the Department of Transplant Surgery when they discovered that the liver to be transplanted was bad. The liver, which had been flown in from another country in the Nordics, was both stiff and full of scarring. – But since they had already opened me, they had no choice. They had to put it in, he says. Section chief physician Morten Hagness says a wrong assessment was made abroad of the liver Ole Kasper Næss was supposed to receive. Photo: Håvard Greger Hagen / news – Bought us time – We chose to insert the liver, even though it was not of optimal quality, because we knew we would get a new liver that worked well within a short time. By inserting that liver, we bought ourselves time, says Morten Hagness. He is a section chief at the hospital and says that they work under time pressure when they carry out organ transplants, and that in Ole Kasper’s case they had to remove the old liver before they had inspected the new one. – There was nothing to indicate that there was anything wrong with the liver we received from abroad, says Hagness. He says the donor was young and previously healthy. – The fact that a donor surgeon in another country overlooked that something was wrong shows how difficult this is to assess. However, it was clear to us as soon as we felt the liver, that there was something wrong here. Afterwards it turned out to be fibrosis. This is extremely rare in young, healthy people, says the section supervisor. He says that they have great trust in each other in the Nordic centres. Hello! Do you have any input? Hi. Do you know of other conditions within this field that we should investigate, or do you have something on your mind? Feel free to contact us by e-mail in the first instance. We have previously written about: – Had bad luck – Was a frozen section or biopsy taken on it the center abroad? – No. – Should it have been done? – Basically, this is an extremely rare condition, and we do not do it routinely. – Was the degree of fibrosis assessed abroad? – No. – Should you know about this before the patients are opened in Oslo? – Given the premise that there is fibrosis here, we should of course have known this in Oslo. But the premise here was that it was a young, healthy donor. – Do you think the procedures are good enough? – The assessment of whether to do biopsies of all livers is an ongoing discussion. This was extremely unlucky. On the other hand, this was a liver that worked well enough for us to keep him alive. It may well have worked for years. But we chose to replace it because we didn’t think this would be a lasting solution for him, says the section supervisor. – Was the matter reported to the Norwegian Health Authority? – No, the fact that the donor liver does not work is a predictable event in liver transplantation. This was not reportable as we see it, says Hagness. Ole Kasper Næss and Line Østvang do, among other things, deer breeding on the farm. Photo: Trond A. Stenersen / news Getting scared Ole Kasper contacted both news and a lawyer when he saw the case of 50-year-old Sigrun K. Marcussen, who was admitted to the same section half a year earlier. After three liver transplants in 13 days, she died. – It is terrifying. I get scared, because I am in such a situation that I could end up there again with the illness I have, says Ole Kasper. He points out that he is grateful to the doctors and is not looking to take down individuals. – The surgeons did a fantastic job, which after all saved my life after such a complicated course of surgery. I feel that there is something wrong with the system and routines, he says. Via a lawyer, Ole Kasper has reported the case to both the Norwegian Health Authority and Norwegian Patient Injury Compensation (NPE). – They told me that this should not happen, so I thought that it was automatically reported. – Have you had any problems afterwards? – Yes, I am in a lot of pain. I sleep very badly, and then I’m very scared. This has scared me a lot, and I think a lot that I could end up in this situation again, says Ole Kasper. Demanding intervention Section head Morten Hagness points out that liver retransplantation is a very demanding intervention. – It often involves significant adhesions in unwell patients. You really have to step up and have a good team in place to carry out these interventions. The alternative is that these patients die on the waiting list. So we must dare to retransplant them, he says. He further says that Norway is in a good position compared to other countries. – Compared to the rest of Scandinavia, we offer this procedure to more people than other countries, and we have at least as good results and significantly lower mortality than the average in Scandinavia, says Hagness. Hagness says that they are in dialogue with the center abroad that evaluated the liver that was inserted into Ole Kasper. He does not want it to be known which center it is for the sake of the donor and next of kin. – Who is responsible in this case? – The center abroad is responsible for assessing the quality of the organ, but the responsibility for the organ that is inserted, however, lies with the surgeon in Oslo. – Did you rely too much on the foreign centre? – 25 percent of the organs we transplant in Norway are moved across national borders. We completely trust our collaborative partners, says Hagness. Published 03.07.2024, at 19.57



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