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<v Speaker 1>Initialize sequence.

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<v Speaker 2>Coming to you live from Houston, Texas, home to the

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<v Speaker 2>world's largest medical summer.

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<v Speaker 3>In a bunch of bays. Every day we lead gremony

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<v Speaker 3>rode Conti.

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<v Speaker 2>After this is your Health First, the most beneficial health

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<v Speaker 2>program on radio with doctor Joe Glotti.

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<v Speaker 3>During the next.

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<v Speaker 2>Hour you'll learn about health, wellness and the provention of disease.

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<v Speaker 2>Now here's your host, doctor Joe Bellotti. Well la marvelous

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<v Speaker 2>Sunday Evening to everybody, Doctor Joe Galotti. As usual, we're

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<v Speaker 2>here every Sunday between just an hour between seven and

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<v Speaker 2>eight pm Central time. And if you're traveling over the summer,

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<v Speaker 2>don't forget. You can catch us anywhere in the globe

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<v Speaker 2>if you go to the iHeartRadio app type in KTRH

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<v Speaker 2>and we will be here at seven o'clock Central time.

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<v Speaker 2>And my goal is, I say, every Sunday evening, we

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<v Speaker 2>want to make you better consumers of healthcare. We want

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<v Speaker 2>to raise your health IQ so that you really really

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<v Speaker 2>understand how the body works, what that pain in your

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<v Speaker 2>stomach means, and that you don't blow things off out

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<v Speaker 2>of not wanting to be well, but just I hate

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<v Speaker 2>to use the word ignorant, you're just ignorant of what

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<v Speaker 2>a particular problem is. So that is our goal. We're

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<v Speaker 2>going to raise your health. I q our website doctor

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<v Speaker 2>Joegalotti dot com. You can send me a message, sign

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<v Speaker 2>up for own newsletter. All of our social media info

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<v Speaker 2>is there now. On the program tonight in the studio

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<v Speaker 2>to veteran of the radio program, doctor Caroline Simon and

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<v Speaker 2>Elie Chia. They are transplant surgeons at Houston Methodist Hospital.

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<v Speaker 2>They are colleagues, friends of mine, co workers in the

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<v Speaker 2>marvelous liver transplant program that we have at Euston Methodist,

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<v Speaker 2>and they're going to discuss the robotic surgery that they do,

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<v Speaker 2>but also in the setting of live liver donation. So

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<v Speaker 2>when you do liver transplant, you have this idea. You

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<v Speaker 2>get a liver from somebody that is brain dead and

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<v Speaker 2>they donate their liver and it is recovered and planted

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<v Speaker 2>into the recipient the person that is going to be

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<v Speaker 2>allocated that liver. But here a healthy adult will donate

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<v Speaker 2>half of their liver, but that has to be surgically

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<v Speaker 2>taken out, and that is what their expertise is here.

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<v Speaker 2>So they'd previously been on the program, but it's about

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<v Speaker 2>a year and a half, a little bit of an

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<v Speaker 2>update on new technology and how the program is going

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<v Speaker 2>and what all of you need to know, So stay

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<v Speaker 2>tuned for that. A couple of articles in the news

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<v Speaker 2>that caught my eye. Now this one is for those

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<v Speaker 2>that feel marijuana is completely benign. Everybody should smoke it.

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<v Speaker 2>Why should there be laws to limit it in any way. Well,

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<v Speaker 2>an article came out this week that is associating a

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<v Speaker 2>link with heart attack and stroke. And the general consensus

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<v Speaker 2>is that the general population feels that marijuana is safe.

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<v Speaker 2>But new research that was just published showed that there's

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<v Speaker 2>an associated risk with a associated higher risk which stroke

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<v Speaker 2>and heart attack, including amongst young adults. So this was

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<v Speaker 2>a study that looked at twenty four different research studies

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<v Speaker 2>and it was published in the journal Heart, and it

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<v Speaker 2>found that marijuana use was associated with a twofold increase

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<v Speaker 2>in the risk of death from cardiovascular disease. Now, you

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<v Speaker 2>have to be careful in how you analyze the data.

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<v Speaker 2>It is not a direct correlation, but the relationship is there.

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<v Speaker 2>But it's very tough to prove that smoking marijuana caused

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<v Speaker 2>all of these problems. Now, what they think the problem

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<v Speaker 2>is it is a rise in blood pressure and a

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<v Speaker 2>rise in heart rate, as well as cardiac arrhythmia, so

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<v Speaker 2>irregular beating of the heart, the electrical system goes a

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<v Speaker 2>little bit berserk, and that is what they think is

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<v Speaker 2>the culprit. Now speaking, older adults and people with underlying

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<v Speaker 2>conditions like diabetes, high cholesterol, pre existing heart disease, they

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<v Speaker 2>are going to be the greatest at risk. And certainly

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<v Speaker 2>there are more older adults, a lot of baby boomers

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<v Speaker 2>that are using marijuana, either recreationally or for some kind

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<v Speaker 2>of medical use, and so they are definitely more at risk. Now.

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<v Speaker 2>In twenty twenty three, about seven percent of the US

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<v Speaker 2>adults sixty five and old are reported using marijuana within

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<v Speaker 2>the last month, So that's a fair amount of people

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<v Speaker 2>that are that are using it now. The other somewhat

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<v Speaker 2>alarming part is that younger, younger adults sort of in

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<v Speaker 2>that thirty five to forty range are coming in with

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<v Speaker 2>heart attack, but a lot of them don't know what

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<v Speaker 2>the signs and symptoms of a heart attack or stroke are,

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<v Speaker 2>so they're sort of getting diagnosed a bit late. And

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<v Speaker 2>so what do we do well, I would think certainly,

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<v Speaker 2>if you're an older adult, you have to be very careful.

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<v Speaker 2>Talk with your doctor if you are using marijuana. If

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<v Speaker 2>you are younger and using marijuana, you probably need to

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<v Speaker 2>get a good checkup to make sure you don't have highpertension,

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<v Speaker 2>you don't have diabetes, there's no rhythmias with your heart.

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<v Speaker 2>The amount of people that have a FIB has gone

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<v Speaker 2>up four hundred percent in the last ten years, so

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<v Speaker 2>there's a lot of people with underlying heart disease that

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<v Speaker 2>may not realize it. So buyer, beware, proceed with caution.

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<v Speaker 2>All right. With that said, we're gonna take a quick

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<v Speaker 2>break here in the wings. Doctor Simon and doctor Chia

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<v Speaker 2>will be here gracing our airwaves. I'm doctor Joglotti. Doctor

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<v Speaker 2>Jogolotti dot com is our website. Stay tuned, we will back.

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<v Speaker 2>As of this morning, they were approximately nine one hundred

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<v Speaker 2>and twenty eight Americans waiting for a liver transplant all

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<v Speaker 2>around the country, big cities, small cities, And that is

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<v Speaker 2>a real challenge. And I'm very fortunate to be part

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<v Speaker 2>of a world class liver transplant program. And in the

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<v Speaker 2>studio today are two stars, doctor Carolyn Simon and doctor

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<v Speaker 2>Eeli Chia. They're sort of veterans of the program and

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<v Speaker 2>they've been begging me to come back on the program.

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<v Speaker 2>So doctor Simon, doctor Chia, welcome and so glad you

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<v Speaker 2>come back and share your knowledge with everybody tonight about

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<v Speaker 2>liver transplant and more importantly robotic surgery.

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<v Speaker 1>Thanks for inviting us, Thanks for having us back to you.

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<v Speaker 2>Absolutely so happy. So if there are people listening that

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<v Speaker 2>didn't catch you the first time about eighteen months ago,

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<v Speaker 2>so really quick introduction about yourselves and your training, your

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<v Speaker 2>background and what you do here in Houston.

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<v Speaker 1>My name is Caroline Simon, so.

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<v Speaker 2>Everybody knows that is Caroline. Doctaccia will be number two here.

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<v Speaker 3>Yeah, I've been in Houston now for just over two

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<v Speaker 3>and a half years. I was trained in kind of

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<v Speaker 3>a mixture. My med school was done in Ireland and

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<v Speaker 3>my residency and fellowship was done in the Northeast between

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<v Speaker 3>Rhode Island and Boston. I specialize in hepatobilliary and pancratic surgery,

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<v Speaker 3>how to do it open as well as robotically like

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<v Speaker 3>you were saying, and then I also do living down

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<v Speaker 3>a liver transplants. The recipient part.

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<v Speaker 2>Right right Doctachia number two. This is a get your

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<v Speaker 2>left and right speakers set here.

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<v Speaker 4>Hi, I'm a Yilicia. I'm the director of the Robotic

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<v Speaker 4>living don A liver transplant program at Houston Methodists.

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<v Speaker 1>I follow.

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<v Speaker 4>A similar path to doctor Simon. I graduated from an

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<v Speaker 4>Irish medical school and then I did most of my

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<v Speaker 4>training in Brown and Leahy Clinic in Massachusetts. And my

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<v Speaker 4>passion is living down a surgery where I look after

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<v Speaker 4>healthy patients who want to donate part of the liver

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<v Speaker 4>to help someone on the waiting list.

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<v Speaker 2>Right exactly. Now, we've talked about robotic surgery, and there

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<v Speaker 2>are people sitting there saying, robotic surgery totally automated. What

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<v Speaker 2>some something that Elon Musk is going to make is

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<v Speaker 2>going to come and do the surgery. So don't why

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<v Speaker 2>don't you both explain what exactly robotic surgery is.

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<v Speaker 3>I'll take that it's basically computerized surgery allows us to

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<v Speaker 3>perform really fine movements, really complex surgery through very very

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<v Speaker 3>tiny incisions, you know, smaller than your finger. It is

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<v Speaker 3>a common misconception, you know, even my mom would say that, oh,

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<v Speaker 3>you set the robot and it just goes off in

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<v Speaker 3>the room and right exactly, but there's no self parking,

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<v Speaker 3>there's no self driving assist modes. Here, this is just

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<v Speaker 3>you know, augmented to make so basically you control the robot.

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<v Speaker 3>You control everything it does, and that's what makes it

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<v Speaker 3>so cool.

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<v Speaker 2>Yeah, what do you think?

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<v Speaker 4>Yeah, it's kind of like a remote operated vehicle, except

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<v Speaker 4>the surgeon is no longer at the bitside, but is

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<v Speaker 4>like sitting in a console with the hand controls and

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<v Speaker 4>foot pedals that will enable us to use different kinds

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<v Speaker 4>of energy devices to help us with to stop bleeding

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<v Speaker 4>or to cut through the liver, right, and there's usually

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<v Speaker 4>a separate surgeon or a system at the bedside to

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<v Speaker 4>help us changing instruments and any kind of like sectioning

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<v Speaker 4>assistance that we may need.

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<v Speaker 3>Right.

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<v Speaker 2>So, the sense is you're in the room, you're doing

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<v Speaker 2>the surgery, the surgeon is doing the surgery. The robot

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<v Speaker 2>really is just a super cool tool that you are

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<v Speaker 2>using at you know, ten feet away.

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<v Speaker 3>Absolutely, you know, it also makes you.

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<v Speaker 1>A slightly different surgeon.

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<v Speaker 3>And what I mean by that is automatically, you have

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<v Speaker 3>two right hands and two left hands, right, and so

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<v Speaker 3>think of all the things that you could do with

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<v Speaker 3>an extra couple of hands. Right. It also makes you

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<v Speaker 3>automatically and be dexterous and so you could, you know,

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<v Speaker 3>throw the same amount of sutures and cut and dissect

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<v Speaker 3>the same way right handed or left handed and looks

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<v Speaker 3>exactly the same.

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<v Speaker 2>You know, you look at different and physicians and any

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<v Speaker 2>specialty and you'd almost look at them in different eras

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<v Speaker 2>as far as they're training. So you graduated medical school

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<v Speaker 2>in the late nineteen seventies, and you did your training

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<v Speaker 2>through the eighties, and here you are. What is how

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<v Speaker 2>is the retrofitting of surgeons to pick this up? Where?

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<v Speaker 2>And you know, we're not naming names to say this

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<v Speaker 2>guy shouldn't be doing it or she's a disaster, but

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<v Speaker 2>where do you think this is? Is this truly a

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<v Speaker 2>new generation of surgeons and physicians that are getting involved

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<v Speaker 2>in this versus the retrofitting? You know, should we really

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<v Speaker 2>have high hopes for that?

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<v Speaker 4>I think it goes both ways, because the current generation

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<v Speaker 4>of junior surgeons who have graduated from official training, they

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<v Speaker 4>are trying to pick up the robot because they're at

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<v Speaker 4>a I guess a time in their careers where they

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<v Speaker 4>can still pick up new technology pretty easily.

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<v Speaker 1>So I'm one of those so.

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<v Speaker 4>Called retrofitted surgeons because I had no exposure to robotic

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<v Speaker 4>surgery during training, and that takes a lot of self

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<v Speaker 4>motivation and learning, sure to kind of figure out how

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<v Speaker 4>the device works, how the equipment will help you do

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<v Speaker 4>the surgery and kind of operate in a very different way.

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<v Speaker 4>One of the fallbacks of the robot is that as

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<v Speaker 4>opposed to open surgery, you don't have any teachtile feedback.

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<v Speaker 4>You can't feel the liver, you can't feel the tissues

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<v Speaker 4>as you're sewing it. And that's something that someone who's

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<v Speaker 4>learning that technology will have to figure out and takes,

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<v Speaker 4>you know, methods like simulation training, training on cadever models,

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<v Speaker 4>biotissue models to try and figure that out.

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<v Speaker 2>Sure, yeah, and I would think most people don't think

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<v Speaker 2>about that that you're actually not touching and feeling and

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<v Speaker 2>so much of that is important when you're doing you're

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<v Speaker 2>doing surgery. So as a retrofit in the fifteen years,

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<v Speaker 2>how tell everybody how far the technology has come from

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<v Speaker 2>you know, version one point oh robot that you vers

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<v Speaker 2>first sat with, versus what you're going to be dealing

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<v Speaker 2>with tomorrow morning.

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<v Speaker 4>I think the first robot was mainly used by our

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<v Speaker 4>urology colleagues and they've really pushed the development of better robots.

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<v Speaker 4>When we first started the robotic surgery and the liver

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<v Speaker 4>and pancreas, it was like the third generation robot, and

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<v Speaker 4>there was still some disadvantages to the technology. But with

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<v Speaker 4>the current fourth generation and the most recently released fifth

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<v Speaker 4>generation robot, they've kind of overcome a lot of those

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<v Speaker 4>difficulties and added some safety features that I think helps

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<v Speaker 4>with a surgery like liberal panker surgery, where you know,

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<v Speaker 4>there is a sense that you need to have better

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<v Speaker 4>control to help with bleeding and any kind of those

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<v Speaker 4>like fine futuring that we will need for operations in.

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<v Speaker 2>Yeah, Caroline, what would you say is the new cool

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<v Speaker 2>feature that you've had for the past few years compared

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<v Speaker 2>to five ten years ago that maybe just didn't exist.

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<v Speaker 3>I think they've made the camera a little bit more functional.

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<v Speaker 3>You know, it's smaller, it white balance is better, right.

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<v Speaker 3>You tend not to think about it, but you know,

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<v Speaker 3>in a cavity, especially if it's say, you know, a

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<v Speaker 3>certain type of pink or a certain type of red,

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<v Speaker 3>white balancing is actually pretty important, and so that's actually

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<v Speaker 3>gotten better. The other thing that we're able to do

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<v Speaker 3>is we're able to inject a substance called ICG or

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<v Speaker 3>indosyanine green. We can change the light models and have

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<v Speaker 3>immunofluorescence kind of guide us for different parts of the surgery.

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<v Speaker 3>It can show you blood vessels, it can show you

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<v Speaker 3>where to cut on the liver, it can show you

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<v Speaker 3>where the bio ducts are. And then also the instruments

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<v Speaker 3>that we have that's gotten better too. You know, there's

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<v Speaker 3>more joint it's more functional. Like doctor Chio was saying,

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<v Speaker 3>the ceiling or the grip the yeah, the grip that

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<v Speaker 3>the heating elements or the cattery elements that that's gotten

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<v Speaker 3>better too.

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<v Speaker 2>Yeah, you know. I would I would say that the

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<v Speaker 2>average average person listening tonight, which I like to think

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<v Speaker 2>they tend to be very health motivated or health conscious,

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<v Speaker 2>really they have no idea what this looks like in there.

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<v Speaker 2>I remember, I don't know if you were visiting I

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<v Speaker 2>think you were visiting Houston, and you're standing there at

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<v Speaker 2>the podium and you flip up this video and I

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<v Speaker 2>think everybody, the chairman of Surgery was there gaping with

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<v Speaker 2>mouth open, thinking this is really unbelievable. I went to

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<v Speaker 2>him afterwards, this is doctor Gaber at the time, and

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<v Speaker 2>I said this is unreal, and he said it is,

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<v Speaker 2>it is. It really is coming a long way. So

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<v Speaker 2>we have these topics tonight to talk about really for

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<v Speaker 2>the average citizen to really understand what is available to them.

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<v Speaker 2>Last word before we take a break, Doctor.

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<v Speaker 4>Chiah Joe, I just want to say that I know

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<v Speaker 4>the videos look pretty cool and the technique is really

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<v Speaker 4>nice and clean, but the reason why we move into

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<v Speaker 4>robotics is because it's actually better for a patient. Yes, right,

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<v Speaker 4>because the incisions are smaller and the recovery faster.

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<v Speaker 2>Yeah. Yeah, I you know, robotics has trickled down to

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<v Speaker 2>everything and I've in some knee issues that I've been

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<v Speaker 2>having talking to the surgeon saying, oh, yes, we could

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<v Speaker 2>fix that robotically, and like robotically, it's we're talking about

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<v Speaker 2>a small area. No, we're going to fix it robotically.

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<v Speaker 2>So it's fascinating. All right, Well, we have doctor Chia

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<v Speaker 2>and doctor Simon for the whole hour here, so don't

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<v Speaker 2>miss anything. Doctor Joeglotti dot com is our website. You

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<v Speaker 2>can actually message me if you have any questions. Stay tuned.

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<v Speaker 2>We will be right back. Welcome back, everybody, playing a

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<v Speaker 2>little Billy Joel while we're filling some time here tonight,

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<v Speaker 2>but don't forget every Sunday night between seven and eight pm,

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<v Speaker 2>we are here Raising your Health IQ, bringing you the

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<v Speaker 2>best experts in health and wellness. And I'm so pleased

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<v Speaker 2>to have doctor Carolyn Simon and Ylie Chia surgeons at

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<v Speaker 2>Houston Methodist Hospital, part of the liver transplant program that

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<v Speaker 2>we have there. And we are talking about both robotic surgery,

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<v Speaker 2>but living donation, live living donation, liver transplant. I get

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<v Speaker 2>that to live liver. When I on my Siri and

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<v Speaker 2>I say live liver, it goes liver liver or live

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<v Speaker 2>live and doesn't quite work all the time. But we

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<v Speaker 2>are talking about taking a healthy life liver or part

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<v Speaker 2>of a liver from a healthy donor and putting it

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<v Speaker 2>into a person that is in dire need of needing

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<v Speaker 2>a liver transplant. So, doctor Simon, what is the general

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<v Speaker 2>concept of live liver donation? What do the people tonight

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<v Speaker 2>need to know?

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<v Speaker 3>The basic fact that your liver can regenerate and so

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<v Speaker 3>if you are willing and able to donate, you know

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<v Speaker 3>a portion of your liver you can help save someone

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<v Speaker 3>else's life.

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<v Speaker 2>Right, And I actually I've got the numbers here national data.

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<v Speaker 2>So back when I broke into transplant nineteen eighty nine,

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<v Speaker 2>there were two live liver donations done transplants, probably in kids,

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<v Speaker 2>and then nineteen ninety was fourteen, and then twenty two

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<v Speaker 2>into the thirties. But last year six hundred and four,

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<v Speaker 2>six hundred and four live donor transplants. So again, it's technology,

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<v Speaker 2>it's knowledge, it's no how from people like you, so

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<v Speaker 2>expand on that.

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<v Speaker 3>You know.

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<v Speaker 2>I mentioned there are almost ten thousand people waiting for

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<v Speaker 2>liver transplants, and despite the best of care, the technology

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<v Speaker 2>that we offer them before transplant, we're still losing nationwide,

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<v Speaker 2>somewhere between twelve to fifteen percent of patients waiting for

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<v Speaker 2>a liver. They've been approved good candidates, their heart, their lungs,

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<v Speaker 2>their kidneys, their insurance, everything is good. But yet they

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<v Speaker 2>get too sick and they die, which is always horribly

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<v Speaker 2>sad for everybody. But this live donor program is really

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<v Speaker 2>a stop gap to cut that down.

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<v Speaker 1>Yeah, So Joe.

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<v Speaker 4>Structured so that there is prioritization of the sickest patients,

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<v Speaker 4>patients who are about to die, and they will get

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<v Speaker 4>offered deceased donor organs from people who did and are

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<v Speaker 4>willing to donate their organs. The problem is there are

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<v Speaker 4>not enough of those organs to go around to those

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<v Speaker 4>over nine thousand people. When you have a living donor

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<v Speaker 4>come forward, that living donor is giving a directed gift

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<v Speaker 4>to someone on the recipient list, and the living donor

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<v Speaker 4>is not going to care where they are on the

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<v Speaker 4>waiting list. So what the living donor does is that

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<v Speaker 4>they take the patient out of the queue, out of

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<v Speaker 4>the waiting list, and donate part of their liver to them.

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<v Speaker 4>They will get a liver transplant, and it also frees

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<v Speaker 4>up a DC's donor organ for someone else on the

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<v Speaker 4>waiting list who can only access DC's donor organs. So

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<v Speaker 4>technically a living donor can save two lives right.

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<v Speaker 2>Now, there is the sense that it has to be

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<v Speaker 2>a relative. It is my brother, it is my sister,

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<v Speaker 2>it is my wife, it is my husband. What's your

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<v Speaker 2>experience been with who are these candidates that you're operating on.

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<v Speaker 4>Well, usually the donor has some sort of emotional connection

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<v Speaker 4>to the recipient, even though there are people who are

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<v Speaker 4>altruistic in a sense that they have no relationship to

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<v Speaker 4>the recipient. They just want to donate an organ to them.

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<v Speaker 4>But most of our living donor. Donors for liver are

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<v Speaker 4>emotionally connected to the recipients, but they don't have to

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<v Speaker 4>be relatives. In fact, fifty percent of our living donors

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<v Speaker 4>are friends or family of friends and friends of family, right,

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<v Speaker 4>so sort.

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<v Speaker 2>Of like your phone, friends and family get a discount.

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<v Speaker 4>So the most important thing is that they have to

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<v Speaker 4>be volunteers for this procedure.

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<v Speaker 1>They need to understand the risk.

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<v Speaker 4>They will get educated during the work up for limit

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<v Speaker 4>donation and they get a very terough process of evaluation

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<v Speaker 4>where you make sure that they are fit for major surgery.

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<v Speaker 4>Number one and number two, their liver is fit to

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<v Speaker 4>be donated, as it has to be split appropriately into two,

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<v Speaker 4>with a pot that can be transplanted into recipient and

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<v Speaker 4>the remnant that stays in the donor will regenerate as well.

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<v Speaker 2>Right you know, Caroline, As I said this before, a

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<v Speaker 2>lot of people don't know that much about the liver,

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<v Speaker 2>but they know one thing it regenerates. And I would

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<v Speaker 2>think that with what you are both doing, this is

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<v Speaker 2>the ultimate case of regeneration. You're taking half the liver

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<v Speaker 2>out and within weeks the liver is back to.

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<v Speaker 3>Normal, absolutely, right, you know, you get two thirds of

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<v Speaker 3>the growth happening within the first two months, and then

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<v Speaker 3>kind of that exponential growth tailors off a little bit.

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<v Speaker 3>You know, within six months to a year, you're back

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<v Speaker 3>to full size.

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<v Speaker 2>Yeah, how would you you've been at live donor programs

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<v Speaker 2>up at the Late Heat Clinic. How would you say

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<v Speaker 2>the program here at Methodist is different, sim s Oller upgrades.

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<v Speaker 2>Where would you say you're at with that?

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<v Speaker 4>We started living on a lover transplant in Lahay Clinic

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<v Speaker 4>because the allocation system of Massachusetts made it very difficult

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<v Speaker 4>for our program to get a disease donor organs. So

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<v Speaker 4>living on a liver transplant made up about twenty percent

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<v Speaker 4>of total transplants the Massachusetts VERSU in Houston. You know,

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<v Speaker 4>we have a much larger, more established disease donor program

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<v Speaker 4>at Houston Netodis, but our waiting liss is four hundred

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<v Speaker 4>plus patients and there's still a signment number of patients

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<v Speaker 4>on the waitings who would benefit from living on a

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<v Speaker 4>liver transplant, which was why the leadership of our transplant

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<v Speaker 4>program wanted to bring us here to start living on

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<v Speaker 4>a lover transplants to help those people who have no

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<v Speaker 4>access to the diseased donor augans.

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<v Speaker 2>Yeah, and many many patients which the allocation the sickest patients,

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<v Speaker 2>like you said, they are near death. Those are the

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<v Speaker 2>ones we're transplanting. But a lot of our patients in

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<v Speaker 2>this scoring system, they're in they're in purgatory, they are sick,

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<v Speaker 2>they're in and out of the hospital. They're there, they

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<v Speaker 2>can't work, they can't take care of their family. But

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<v Speaker 2>yet they look at us and they say, get me

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<v Speaker 2>a liver, get my husband deliver this really is that

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<v Speaker 2>that vehicle to make all of that happen.

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<v Speaker 3>Absolutely, you know, friends, family members, if they can, you know,

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<v Speaker 3>put the word out that you know, my loved one

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<v Speaker 3>needs a liver. Like you said, you know, you don't

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<v Speaker 3>have to be related, right, you know, you just have

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<v Speaker 3>to be a willing, healthy volunteer, get tested and you

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<v Speaker 3>know that that's about it.

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<v Speaker 2>Yeah. Yeah, what I want to do on the final

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<v Speaker 2>saman the final segments coming up, we're gonna have to

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<v Speaker 2>come and do the radio station and take it, take

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<v Speaker 2>it another hour. I really want to get into this

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<v Speaker 2>screening process, and a lot of it is online to

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<v Speaker 2>start off with, as a as a weeding system to

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<v Speaker 2>get people and just really sort of end the evening

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<v Speaker 2>with everybody having a good sense of how this works

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<v Speaker 2>and why it's important not only to take care of

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<v Speaker 2>your liver, but understand how these programs and processes work.

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<v Speaker 2>All right, final segment coming up, This is Your Health First.

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<v Speaker 2>I'm doctor Joe Glotti here with doctor Chia and doctor

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<v Speaker 2>Simon on Your Health First. We'll break back final segment

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<v Speaker 2>of this week's Your Health First, every Sunday between seven

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<v Speaker 2>and eight pm. I'm doctor Joe Galotti. Doctor Joeglotti dot

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<v Speaker 2>Com is our website. Go there to learn more about

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<v Speaker 2>the program, send me a message. All of our social

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<v Speaker 2>media is there, and we are blessed to have doctor

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<v Speaker 2>Carolyn Simon and doctor ye Lee Chia from Houston Methodist

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<v Speaker 2>here in the studio with us. I think they're having

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<v Speaker 2>a good time.

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<v Speaker 1>Oh yes, absolutely, yeah, this.

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<v Speaker 2>Is the place on Sunday night. So in the short

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<v Speaker 2>time that we have left, the evaluation of potential donors.

422
00:27:09.720 --> 00:27:11.480
<v Speaker 2>How is that done, doctor Chia?

423
00:27:12.039 --> 00:27:14.759
<v Speaker 4>So they start by filling in a health questionnaire online

424
00:27:14.960 --> 00:27:17.920
<v Speaker 4>and the team will look at the questionnaire and if

425
00:27:17.920 --> 00:27:20.680
<v Speaker 4>we deem that they're suitable for further evaluation, they will

426
00:27:20.720 --> 00:27:24.880
<v Speaker 4>do a set of screening labs, just basic stuff, and

427
00:27:24.920 --> 00:27:27.319
<v Speaker 4>then if we find that those are appropriate, we will

428
00:27:27.359 --> 00:27:30.319
<v Speaker 4>bring them in for full evaluation. That's usually to a

429
00:27:30.359 --> 00:27:33.039
<v Speaker 4>three day process where they see all the members of

430
00:27:33.079 --> 00:27:36.759
<v Speaker 4>the team and each one will kind of evaluate specific parts,

431
00:27:36.799 --> 00:27:40.559
<v Speaker 4>you know, including the surgical aspect of the donation, and

432
00:27:40.599 --> 00:27:43.880
<v Speaker 4>if they're suitable surgically, someone like you doctor Galati, will

433
00:27:43.920 --> 00:27:46.599
<v Speaker 4>evaluate them medically and make sure they are medically stable

434
00:27:46.640 --> 00:27:50.960
<v Speaker 4>for donation. They also see a psychiatrist, a social worker,

435
00:27:51.880 --> 00:27:55.920
<v Speaker 4>the pharmacists, the dietitians, so everyone on the team will

436
00:27:55.920 --> 00:27:58.960
<v Speaker 4>contribute a report that we will discuss at our multi

437
00:27:58.960 --> 00:28:02.440
<v Speaker 4>discipline reading meeting, and then we'll decide as a committee

438
00:28:02.440 --> 00:28:04.920
<v Speaker 4>better than doble for liber donations.

439
00:28:05.079 --> 00:28:09.599
<v Speaker 2>Right now, in your current experience, the number of people

440
00:28:09.640 --> 00:28:12.799
<v Speaker 2>that come forward that are weeded out, what what's your

441
00:28:13.559 --> 00:28:16.160
<v Speaker 2>conversion rate in a sense, it's.

442
00:28:16.000 --> 00:28:17.799
<v Speaker 1>Probably around fifty.

443
00:28:18.240 --> 00:28:24.400
<v Speaker 2>So the fifty percent that are disqualified, doctor Simon, what

444
00:28:24.400 --> 00:28:28.559
<v Speaker 2>what are the concerns that you have or the group has.

445
00:28:28.279 --> 00:28:33.359
<v Speaker 3>With them, Probably that they are not medically fit to donate,

446
00:28:34.519 --> 00:28:38.160
<v Speaker 3>you know. It usually most of the time actually boils

447
00:28:38.160 --> 00:28:41.119
<v Speaker 3>down to either of them being very much overweight or

448
00:28:41.240 --> 00:28:43.279
<v Speaker 3>having some version of metabolic syndrome.

449
00:28:43.400 --> 00:28:46.279
<v Speaker 2>Right, so they're diabetic and and you know this is

450
00:28:46.319 --> 00:28:48.880
<v Speaker 2>where we talk so much about that here, these are

451
00:28:48.920 --> 00:28:52.640
<v Speaker 2>the circumstances where you may be sitting at home saying, oh,

452
00:28:52.960 --> 00:28:55.640
<v Speaker 2>you know, who cares if I'm overweight twenty pounds or

453
00:28:55.680 --> 00:28:58.599
<v Speaker 2>I've got to touch a diabetes. But that day may

454
00:28:58.640 --> 00:29:00.440
<v Speaker 2>come where you get the call to say, say, hey,

455
00:29:00.920 --> 00:29:03.720
<v Speaker 2>somebody you know may need to be a donor, and

456
00:29:03.759 --> 00:29:07.119
<v Speaker 2>you get washed down. So it's a wake up call

457
00:29:07.200 --> 00:29:09.039
<v Speaker 2>that we still need to take care.

458
00:29:08.920 --> 00:29:12.240
<v Speaker 3>Of ourselves absolutely, and it's actually not forever, right, I mean,

459
00:29:12.319 --> 00:29:16.920
<v Speaker 3>you know yourself, you know, like dieting, exercising, you know,

460
00:29:17.960 --> 00:29:21.359
<v Speaker 3>you can actually change your liver from being a little

461
00:29:21.359 --> 00:29:23.480
<v Speaker 3>bit overweight or a little bit fatty back to being

462
00:29:23.480 --> 00:29:25.480
<v Speaker 3>a normal liver and then being able to donate.

463
00:29:25.599 --> 00:29:30.319
<v Speaker 2>Absolutely. So with the process that somebody is approved this donor,

464
00:29:30.440 --> 00:29:36.519
<v Speaker 2>they make the cut who's going to do the the

465
00:29:36.559 --> 00:29:39.079
<v Speaker 2>donation surgery? Who's going to remove that liver?

466
00:29:39.599 --> 00:29:44.480
<v Speaker 4>So I'm the donor surgeon, okay, And I always try

467
00:29:44.559 --> 00:29:47.279
<v Speaker 4>to offer them a robotic approach, and about two thirds

468
00:29:47.279 --> 00:29:51.160
<v Speaker 4>of our living donors actually undergo a robotic living door surgery.

469
00:29:51.200 --> 00:29:52.400
<v Speaker 1>Right at the moment, Yeah.

470
00:29:52.279 --> 00:29:55.720
<v Speaker 2>Now you had said robotic surgery in general is better

471
00:29:55.720 --> 00:30:01.160
<v Speaker 2>for the patient. So compared to conventional liver surgery versus

472
00:30:01.279 --> 00:30:06.480
<v Speaker 2>the robotic approach, what's the major take home there?

473
00:30:06.880 --> 00:30:09.319
<v Speaker 4>Well, we are talking about small incisions the size of

474
00:30:09.880 --> 00:30:15.240
<v Speaker 4>a pen, with the larger incision used to extract the

475
00:30:15.279 --> 00:30:18.039
<v Speaker 4>graph being in the lower abdomen instead of a large

476
00:30:18.119 --> 00:30:20.359
<v Speaker 4>incision in the upper abdomen that may or may not

477
00:30:20.359 --> 00:30:21.359
<v Speaker 4>split their muscles.

478
00:30:21.920 --> 00:30:22.799
<v Speaker 1>So it's not just.

479
00:30:22.839 --> 00:30:26.960
<v Speaker 4>A cosmetic issue. It's also a patient comfort issue in

480
00:30:27.039 --> 00:30:30.920
<v Speaker 4>terms of pain control after the operation, and we find

481
00:30:30.920 --> 00:30:33.359
<v Speaker 4>that the pain control is so much better to manage

482
00:30:33.680 --> 00:30:36.799
<v Speaker 4>with robotic surgery. And then even when they go home,

483
00:30:37.119 --> 00:30:40.079
<v Speaker 4>our robotic donors tend to go back to work faster.

484
00:30:40.440 --> 00:30:44.119
<v Speaker 2>Right, And again, all of this technology, we are certainly

485
00:30:44.160 --> 00:30:48.960
<v Speaker 2>focused on the recipient and the donor, but these people

486
00:30:49.119 --> 00:30:54.000
<v Speaker 2>talk to their community and say, I as horrible of

487
00:30:54.039 --> 00:30:56.200
<v Speaker 2>a thing that we had to go through because a

488
00:30:56.240 --> 00:30:59.599
<v Speaker 2>loved one was sick. This was a great experience and

489
00:30:59.640 --> 00:31:05.440
<v Speaker 2>hopefully that can promote other people to think, maybe with

490
00:31:05.599 --> 00:31:08.599
<v Speaker 2>my loved one or they know somebody elsewhere that's waiting

491
00:31:08.599 --> 00:31:14.880
<v Speaker 2>for liver. Think about that live donor situation. How is

492
00:31:14.960 --> 00:31:20.359
<v Speaker 2>the implanting that the actual transplant any different. When you

493
00:31:20.400 --> 00:31:22.759
<v Speaker 2>have part of a liver that you're putting in to

494
00:31:22.799 --> 00:31:23.799
<v Speaker 2>where there was a whole.

495
00:31:23.680 --> 00:31:27.359
<v Speaker 3>Liver, the whole liver still needs to be disconnected from

496
00:31:27.400 --> 00:31:29.519
<v Speaker 3>whatever is holding it in place. It comes out, the

497
00:31:29.559 --> 00:31:33.240
<v Speaker 3>new liver sits very nicely in its old spot. Everything

498
00:31:33.279 --> 00:31:36.440
<v Speaker 3>gets sewn in like with like, and then the clamps

499
00:31:36.440 --> 00:31:39.759
<v Speaker 3>get removed and you know, the blood kind of circulates.

500
00:31:39.240 --> 00:31:41.480
<v Speaker 2>Through it turns pink and everybody's happy.

501
00:31:41.839 --> 00:31:43.960
<v Speaker 3>Everyone's happy, yeah.

502
00:31:43.400 --> 00:31:48.680
<v Speaker 2>And anything special the recipient, the person getting the transplant

503
00:31:48.759 --> 00:31:54.680
<v Speaker 2>after they've had a live donor transplant in the weeks

504
00:31:54.720 --> 00:31:58.200
<v Speaker 2>months afterwards, any different than the full liver.

505
00:32:00.400 --> 00:32:01.359
<v Speaker 1>No, not really.

506
00:32:01.440 --> 00:32:06.359
<v Speaker 3>I mean, like I focus a lot on nutrition and

507
00:32:06.440 --> 00:32:10.000
<v Speaker 3>so you know, we do have them do a high calorie,

508
00:32:10.079 --> 00:32:13.880
<v Speaker 3>high protein diet just to enhance the graph regeneration.

509
00:32:14.000 --> 00:32:18.000
<v Speaker 2>Okay, okay, with all your experience combined, do you ever

510
00:32:18.119 --> 00:32:23.160
<v Speaker 2>see does this kind of a surgery a liver transplant ever?

511
00:32:24.319 --> 00:32:27.920
<v Speaker 2>Would it ever be suited for a robotic approach or

512
00:32:28.720 --> 00:32:33.200
<v Speaker 2>a less of an open surgery than what you know

513
00:32:33.279 --> 00:32:35.079
<v Speaker 2>we've been doing for forty years.

514
00:32:35.359 --> 00:32:38.480
<v Speaker 4>Actually, a very small number of centers in the world

515
00:32:38.559 --> 00:32:42.599
<v Speaker 4>have started implanting livers robotically. I think the problem is

516
00:32:42.640 --> 00:32:45.960
<v Speaker 4>oddly enough space because there's only so much you can

517
00:32:46.000 --> 00:32:48.480
<v Speaker 4>inflate the abdomen, and to remove a whole liver and

518
00:32:48.519 --> 00:32:51.480
<v Speaker 4>put a whole new liver in, it's difficult. But the

519
00:32:51.519 --> 00:32:54.480
<v Speaker 4>best results are from a living new liver transplant program

520
00:32:54.559 --> 00:32:56.960
<v Speaker 4>in Saudi Arabia. But you put in a partial graph

521
00:32:57.079 --> 00:32:59.359
<v Speaker 4>through the same incision, you're making the donu a lower

522
00:32:59.400 --> 00:33:03.920
<v Speaker 4>down on the appomen So that seems pretty feasible, but

523
00:33:04.319 --> 00:33:06.039
<v Speaker 4>I'm not sure it is for.

524
00:33:05.960 --> 00:33:07.720
<v Speaker 1>Everybody on the waiting list.

525
00:33:07.799 --> 00:33:10.279
<v Speaker 4>I think we have to be super selective, and it's

526
00:33:10.279 --> 00:33:12.480
<v Speaker 4>too early in our experience to figure out who will

527
00:33:12.480 --> 00:33:13.960
<v Speaker 4>benefit most from me right.

528
00:33:13.759 --> 00:33:17.160
<v Speaker 2>And and we're transplanting sicker patients, and I think that

529
00:33:17.279 --> 00:33:20.359
<v Speaker 2>has to even as a non surgeon that has that

530
00:33:20.480 --> 00:33:24.759
<v Speaker 2>has to calculate in there in the last few minutes here,

531
00:33:25.519 --> 00:33:28.920
<v Speaker 2>doctor Chia and Simon organ donation at the end of

532
00:33:28.920 --> 00:33:32.119
<v Speaker 2>the d at the end of the day, all of

533
00:33:32.160 --> 00:33:37.519
<v Speaker 2>this technology is awesome. I truly hope that the advances continue,

534
00:33:38.240 --> 00:33:43.160
<v Speaker 2>but we still need traditional individuals to be organ donors.

535
00:33:43.799 --> 00:33:45.440
<v Speaker 2>For both of you, what what do you say to

536
00:33:45.440 --> 00:33:48.799
<v Speaker 2>everybody tonight to be an organ donor. Think about it.

537
00:33:50.599 --> 00:33:55.319
<v Speaker 4>I think it's very rewarding for a living donor to

538
00:33:55.440 --> 00:33:59.799
<v Speaker 4>save someone else's life and to be honest, for someone

539
00:34:00.519 --> 00:34:03.559
<v Speaker 4>a recipient who needs a liver transform because of liver cancer,

540
00:34:04.960 --> 00:34:08.159
<v Speaker 4>you can actually save someone's life and cure cancer at

541
00:34:08.159 --> 00:34:11.599
<v Speaker 4>the same time. So I think that's a very rewarding

542
00:34:11.639 --> 00:34:14.760
<v Speaker 4>prospect for living donors, and of course because they're emotionally

543
00:34:14.800 --> 00:34:21.599
<v Speaker 4>connected with the recipient. Yeah, the reward is like enhanced.

544
00:34:21.360 --> 00:34:30.840
<v Speaker 2>Right Dutch Simon speechless, speechless. Yeah, you know, people in

545
00:34:31.199 --> 00:34:37.960
<v Speaker 2>the community, even live donor or regular cadaver donor, there

546
00:34:38.159 --> 00:34:41.320
<v Speaker 2>is this sense that it's not for me. It's not

547
00:34:41.360 --> 00:34:44.679
<v Speaker 2>for me, but it really is for everybody to think about.

548
00:34:45.400 --> 00:34:50.519
<v Speaker 2>And the lives you've all impacted is you know, if

549
00:34:50.559 --> 00:34:54.440
<v Speaker 2>they could see that the impact, it's really tremendous.

550
00:34:54.960 --> 00:34:58.199
<v Speaker 3>Absolutely, everyone can be a living donor. You know, everyone

551
00:34:58.360 --> 00:35:01.159
<v Speaker 3>should think about being a living owner this, you know,

552
00:35:01.239 --> 00:35:03.679
<v Speaker 3>like you mentioned nine thousand plus people on the wait list.

553
00:35:03.760 --> 00:35:07.880
<v Speaker 2>Yeah, yeah, I guess the final question and we got

554
00:35:07.880 --> 00:35:11.000
<v Speaker 2>a minute here real quick, each one of you, what's

555
00:35:11.079 --> 00:35:15.079
<v Speaker 2>your health hack? How do you guys keep healthy? Because

556
00:35:15.119 --> 00:35:17.119
<v Speaker 2>I think it's important for the public to hear how

557
00:35:18.000 --> 00:35:21.400
<v Speaker 2>some high end surgeons here take care of themselves.

558
00:35:22.039 --> 00:35:24.159
<v Speaker 1>For me is really easy. I just see my PCP

559
00:35:24.320 --> 00:35:25.000
<v Speaker 1>every year.

560
00:35:25.920 --> 00:35:26.320
<v Speaker 2>That's it.

561
00:35:26.400 --> 00:35:26.840
<v Speaker 1>That's it.

562
00:35:27.239 --> 00:35:32.480
<v Speaker 3>Okay, I watch what I eat, and you know, try

563
00:35:32.519 --> 00:35:34.679
<v Speaker 3>and exercise a little bit more than you know what

564
00:35:34.719 --> 00:35:35.119
<v Speaker 3>I should.

565
00:35:35.199 --> 00:35:38.199
<v Speaker 2>All right, there you go. All right, well, thank you,

566
00:35:38.559 --> 00:35:41.559
<v Speaker 2>thank you both for coming in, and I think you

567
00:35:41.559 --> 00:35:45.440
<v Speaker 2>you've bought a follow up visit in here for on

568
00:35:45.480 --> 00:35:49.440
<v Speaker 2>the radio. All right, well, I'm doctor Joe Glatti. Every Sunday,

569
00:35:49.840 --> 00:35:53.880
<v Speaker 2>have a great Fourth of July, which is this coming Friday.

570
00:35:53.960 --> 00:35:56.880
<v Speaker 2>I'm going to be out of town. You'll probably get

571
00:35:57.039 --> 00:35:59.960
<v Speaker 2>a best of Maybe we'll play this episode over again,

572
00:36:00.440 --> 00:36:03.400
<v Speaker 2>but have us say fourth of July. I'm doctor Joe Giltti.

573
00:36:03.400 --> 00:36:06.639
<v Speaker 2>Don't forget doctor Joeglotti dot com. We'll see you next week.