The idiom “like father like son” has a whole new meaning for James M. Busic and James “Jim” W. Busic.
Whether it was the elder Busic regularly making the 16-hour round trip in one day from Buffalo, New York, to Long Island just to visit his son, or speaking on the phone almost every day while the father lives in Florida and his son remains in New York with children of his own, the duo have always cherished a close relationship.
But their bond reached new heights on April 18, when Jim Busic donated a portion of his liver to his father.
In addition to helping save his father’s life, Jim Busic became the first patient at the Virginia Commonwealth University Hume-Lee Transplant Center to undergo a fully robotic living donor hepatectomy.
James Busic, a Vietnam War veteran, had suffered from cirrhosis of the liver for decades. His health took a turn for the worse when he was diagnosed with liver cancer over two and a half years ago, he said. He received initial treatments through a Veterans Affairs hospital in Orlando, but the cancer returned last summer. James Busic’s doctors recommended that he receive a liver transplant. He was placed on the national organ donation waiting list in November.
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But the waitlist is over 100,000 people long, which means people often wait months or years for transplants. Approximately 17 people die each day while waiting for an organ.
So when Jim Busic learned about an opportunity last fall to become a living organ donor through a partnership the VA has with transplantation centers across the country — including Hume-Lee — he jumped at the chance to help his father.
“I’ve had a few family members die of cancer, and there was nothing I could do about it and this was something I felt I could do something about,” he said. “It was a no brainer … I was going to do it no matter what.”
As opposed to the process for non-living organ donation, in which the sickest patients on the waiting list receive the first available organs from deceased people, living organ donations transfer organs from living volunteers to those in need of transplants.
Fully robotic hepatectomies
Though not as many organs can be donated through living transplantation, recipients of living organ transplants reportedly have better outcomes and the process helps shorten waiting times, Dr. David Bruno, Hume-Lee interim chair and one of the surgeons who performed James Busic’s transplant, said
The Busics could have chosen any of the three transplant centers in the U.S. that have partnered with the VA to offer veterans living liver transplants. They said they agreed on Hume-Lee upon the recommendation of James Busic’s doctors.
Hume-Lee is one of the oldest transplant centers, and its liver transplant and living donor programs both have ranked among the top ten in the country, according Hume-Lee reports.
Now, after the Busics’ successful procedures, Hume-Lee is one of just three transplant centers in the country conducting fully robotic hepatectomies for living liver transplants, said Dr. Vinay Kumaran, Hume-Lee living donor liver transplantation surgical director. Kumaran performed the operation alongside Dr. Seung Duk Lee, Hume-Lee associate director of liver transplantation. Combined, they have performed over a thousand liver operations.
While it is a relatively new technique that requires a lot of training and skill, robotically-assisted surgery tends to be safer because it is less invasive and offers surgeons better visibility, Bruno said.
During a robotic surgical procedure, a doctor controls a robot, which has four arms that are inserted into the abdomen through four incisions that are approximately 1 centimeter in length each. One of the arms holds a scope that allows surgeons to see where they are operating, Kumaran said.
The smaller incisions compared to traditional operations mean less pain and bleeding, and expedited recovery times for patients because less muscle and tissue is cut.
The procedures also reduce the scarring from mark-stretching across patients’ abdomens to just a few dots below their beltlines. Because recipients’ transplant procedures are more complex, they are still performed traditionally, Kumaran said.
“In a living donor operation, one of the most important parts is making sure the donor is comfortable, and doing it robotically is one more step in that direction,” Kumaran said. “Donors are amazing people. Improving the experience for them will hopefully attract more and increase the number of living donor transplants.”
Doctors around the world have been performing robotically assisted procedures for the past several years. At Hume-Lee, robotics have been used in other abdominal surgeries, including kidney transplants. And there are two more fully robotic living donor liver transplants planned for this summer, Bruno said.
“This is a tough job, but these are the greatest moments when you recognize you’re not only helping the individual, but helping move science of saving people’s lives forward,” Bruno said. “This is the future standard of care. In the next decade I think almost all surgeries will be done robotically.”
Extensive testing and screening
In preparation for the procedure, Jim Busic said, he and his father went through months of extensive medical testing and screening. Jim Busic’s procedure was originally planned as only partially robotically assisted, but Kumaran said his anatomy was just right to perform the surgery fully robotically.
While going through cancer treatments and receiving an organ transplant can be daunting, James Busic said he was most concerned about his son throughout the entire process.
“I was glad, but I was more worried about my son than me,” he said.
This Father’s Day will mark two months since the procedure, and both Busics have reported smooth recoveries so far. Kumaran and Bruno are also optimistic about James Busic’s prognosis, and said he will undergo periodic scans to monitor the cancer.
Regardless of how the procedure was performed, both James and Jim Busic said they are grateful for the extra time they have to spend with each other.
“I jokingly told him that I went through all this so I could get a return on my investment, so I want at least 20 more years with him,” Jim Busic said. “But I’m grateful, we’re blessed and we have a lot more memories to make.”
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