By Angela Marshall
Hurewitz, a dedicated journalist for almost 30 years, was by all accounts healthy when surgeons removed 60 percent of his liver the previous Thursday and placed it in his ailing brother, Adam.
But by Sunday, Hurewitz had become ill and he died in the afternoon, touching off a national debate on the ethics of performing living transplants.
Mount Sinai spokespeople have been instructed by family members not to comment on the condition of Hurewitz's brother, who is chief of pulmonary and critical-care medicine at Winthrop-University Hospital.
Mount Sinai has suspended all adult-to-adult living liver transplants pending an investigation of Hurewitz's death. At press time, the hospital was still keeping silent about what went wrong.
Mount Sinai is conducting a thorough investigation of this case and communicating closely with family members, said a statement released from the hospital on Jan. 15.
State Health Department officials are conducting their own investigation. According to other published reports, state officials said the hospital has been cooperative.
Unlike other organs, the liver has the unique ability to rejuvenate itself, making the transplant possible. Adults have been donating to children with regularity since 1989, but adult-to-adult transplants were considered too risky until recently.
Many surgeons and ethicists felt that the risks to healthy donors like Hurewitz were too high.
But families of those with liver problems kept requesting the surgery.
The reality is that there are not enough donors going around, said Dr. Patricia Sheiner, director of liver transplant at the Westchester Medical Center. People are dying on the list.
A representative from the New York Organ Donor Network said that less than two percent of all cadavers are suitable donors and that only 50 percent of their families choose to donate the body's organs.
There are more than 18,000 on the national liver transplant list, according to the United Network for Organ Sharing, and many will die before an organ becomes available.
Sheiner worked for Mount Sinai for the last nine years and recently made the move to Westchester Medical Center in order to create a living liver transplant program there this year.
The doctor explained that Mount Sinai follows a very strict criteria when deciding whether a potential living donor is acceptable, including performing blood tests and a thorough exam. Doctors use a different set of criteria for donors than for recipients, she said, eliminating people who they do not consider physically fit.
Still, Sheiner said, Every donor is told there is a chance of death.
Prior to Hurewitz's death, there was only one reported death during or directly following a living liver transplant in the United States and three or four in Europe, according to Sheiner. From 1990 to 2000, there were almost 1,000 living liver transplants performed in the U.S.
The doctor said it is hard to calculate the risk donors face but that the chance of death is roughly one in 500.
Although Sheiner does not believe Hurewitz's death will cause a halt to living liver transplants, she does think the medical community will study his case closely to find out what went wrong in order to prevent it from happening again.
That is the response one friend of Hurewitz's believes the journalist would want.
Rick Karlon, a co-worker at the Times Union in Albany, said Hurewitz would be glad to hear that the procedure is being studied for flaws so that others would not suffer the same fate.
