October 3, 2017

Former PM&R Patient First Survivor of High-Risk Transplant Surgery

A daring liver procedure and rehabilitation with the Department of Physical Medicine & Rehabilitation saved Max Bontekoe's life after a near-fatal motorbike accident. He’s the only patient in the world known to have survived this type of surgery.

First Survivor of High-Risk Liver Surgery Heads to College

Minutes after his motorbike collided head-on into his brother’s vehicle while riding through a corn field six years ago, Max Bontekoe was standing, walking and talking.

But internally, the 12-year-old was bleeding to death.

Results of a CT scan at a local hospital prompted doctors to order that the seventh-grader be airlifted to University of Michigan C.S. Mott Children’s Hospital.

When Mott surgical team members led by Ronald Hirschl, M.D., began what they figured would be surgery for a ruptured spleen, they discovered something much worse: Max’s liver was nearly detached from his body, with two of the three veins torn off and the third partially torn.

“It was a surgeon’s nightmare,” Hirschl recalls.

Max was rapidly losing blood, and all methods — including clamping off the aorta to slow bleeding — were unsuccessful. Meanwhile, the blood bank was low on blood.

Hirschl proposed a radical idea to save Max’s life.

“We would have to remove the liver entirely, repair the veins and then put the organ back into his body,” Hirschl says. “It had been done but with limited success.”

That might be an understatement. Only two other patients in the world are known to have survived the high-risk procedure; each lived for only a few days afterward.

It was a delicate gamble. If surgeons couldn’t preserve the liver and fix the injuries, Max would not survive.

Read the rest of the story at the Michigan Health Blog