Transplantation, transformed

In the well-known Greek myth, Zeus is so incensed that Prometheus stole fire from the gods that he condemns the audacious thief to be chained to a rock, where an eagle descends to tear his liver from his body day after day without end. According to transplant surgeon Sukru Emre, M.D., this bizarre punishment suggests that the ancient Greeks knew that the liver is one of the few human organs that can regenerate after injury.

Emre moved to Yale last July from Mt. Sinai Medical Center in New York, where he directed the pediatric and adult liver transplant programs and helped develop Mount Sinai’s transplant surgery fellowship program, one of the most sought-after training programs in the country. He is breathing new life into the Yale-New Haven Organ Transplant Center, just as he’s done for his many patients for whom he’s performed life-saving liver and kidney procedures over the years.

In his short time in New Haven, Emre has already made history by performing the first “split-liver” transplant in Connecticut. The human liver is composed of eight segments, each of which can grow into a complete, functioning organ, and Emre was able to use two sections of a donor’s liver to replace the liver of a 7-month-old boy with biliary atresia, a defect that afflicts about 1 in 10,000 infants and is the most common reason for pediatric liver transplants. The eight-hour surgery to implant the liver section in the infant was performed under a microscope using tiny needles and sutures thinner than a human hair. The remainder of the liver was transplanted into an adult. Both recipients are at home and doing well.

Eventually, Emre plans to perform living donor liver transplantation, another cutting-edge surgical procedure in which he specializes. In this procedure, a liver segment from a live donor is transplanted into a recipient, an operation that has been performed elsewhere in this country and in Europe, but never in Connecticut. There are more than 16,500 Americans awaiting livers for transplant, according to the United Network for Organ Sharing.

“One of the great things about Sukru is that he won’t accept defeat,” says Benjamin Shneider, M.D., the former chief of pediatric hepatology at Mt. Sinai, who adds that he routinely saw Emre conquer “unsolvable clinical problems.”

A native of Turkey, Emre received his medical degree and completed his residency at the University of Istanbul. He did a fellowship in hepatobiliary surgery there before coming to the United States in 1988 to train in transplantation, which “makes you a complete physician,” he says, because of the depth and breadth of medical knowledge it requires.

After finishing a transplantation fellowship at Mount Sinai, he and his wife, Umit Emre, a pediatric pulmonary specialist, decided to stay in the United States so their three daughters could be educated here.

According to Robert Udelsman, M.D., M.B.A., chair and William H. Carmalt Professor of Surgery, Emre’s appointment is part of a $12.5 million investment in Yale’s section of transplantation surgery that will significantly increase the number of surgeons, nurses and support staff. Emre’s mission is to revive a largely inactive liver transplant program while strengthening Yale’s kidney and pancreatic transplant programs. Since his arrival, he has performed four kidney and 12 liver transplants, five in children and seven in adults. The center’s waiting list for liver transplants has grown from about five to 40, and Emre’s goal is to see it grow to between 100 and 150 within a year.

“One of the best universities in the world deserves a great transplant program. That’s my nature; I accept a challenge,” Emre says. “And I don’t give up.”