At first glance, it looked like another liver transplant at Michigan Medicine. Surgeons, colleagues, anesthesiologists, scrub nurses and more crowded the operating room, preparing the patient and performing the hours-long procedure.
But this was no ordinary operation.
A closer look revealed something historic for Michigan Medicine — it was a liver transplant operation led by a team composed entirely of women, a first since the institution began performing such transplants in 1985.
In honor of Women’s History Month, here’s a look at that historic day and why it was so important.
“Women are discouraged from transplants”
The procedure, which took place last winter, was led by Meredith Barrett, MD, a clinical instructor in transplant surgery. She was assisted by colleague Liza Sonnenberg, MD
For Barrett — Michigan Medicine’s first full-time female transplant surgeon — it was a long road to getting to the point where she would direct a liver transplant.
First, she had to get over the staggering numbers: Only 12 percent of transplant surgeons in the US are women.
Then she had to deal with expectations and negative reactions from colleagues and managers at every step of her training.
“Many women are discouraged from undergoing transplants because of their lifestyle,” Barrett said. “I was specifically told that it wouldn’t allow me to start a family and do the other things that society sees as women’s jobs.”
But having a family and being a surgeon are not mutually exclusive.
“My male colleagues are all committed to their families. If men can do it, so can women,” Barrett said. “Our team is working to promote the idea that it is not impossible for a surgeon to have a life outside of the hospital.”
And that view is beginning to spread—at Michigan Medicine and beyond, as Sonnenberg can attest.
“I’ve done a lot of training with female surgeons, including female transplant surgeons leading surgical departments and national societies,” Sonnenberg said. “And now I have several mentors in transplant that I look up to and learn from. It’s an exciting time for a woman in transplant surgery.”
The numbers confirm this excitement. At Michigan Medicine, four of the last eight trained grantees have been women.
A complicated procedure
Both Barrett’s and Sonnenberg’s hard work and long journey culminated on that historic day last winter.
But the operation itself had taken months of preparation.
“There’s a lot that goes into a transplant procedure before it even gets into the operating room,” Barrett said.
For example, a patient must first be screened for a medical need for a transplant. Then a social worker, a nutritionist, and others will assess whether they will be able to handle a rigorous post-surgical recovery.
“There’s a lot of bleeding and it’s a really difficult procedure on the body,” Sonnenberg said. “Because organs are a scarce resource, we need to ensure that patients can not only physically handle the surgery, but also mentally manage the recovery.”
Once approved by all teams, an organ must be identified and harvested. Then the actual operation can begin.
“In total, the procedure will take between six and 15 hours,” said Sonnenberg. “The first part is done by a team from the anesthesiology department, usually a faculty member, colleagues and residents and anesthesia technicians.”
After this, Barrett and Sonnenberg prepare the new liver and remove the old liver. While the surgeons operate, other team members closely monitor the patient and their vital signs to make sure they are stable and able to maintain good blood flow to the new liver.
Once the new liver is sewn in, team members work diligently to ensure it is functioning properly and the patient does not have significant bleeding before the surgery is completed. After many hours in the OR, the patient is transported to the SICU by both the surgical and anesthesia teams for ongoing monitoring and intensive care.
Make it “just another day”
All in all, the last operation was a success. The patient is now home and recovering well.
That’s a great feeling for the surgeons in charge.
“I really feel like I have the greatest job in the world,” Barrett said. “I can take something tragic, like someone dying, and then transplant one of their organs to save someone else’s life.”
And doing it in a historical way is just as satisfying.
“For so many, when they see a woman or other minority in leading roles, they no longer have to wonder if there’s a place for them,” Barrett said. “Here is a place for you and not only is there a place, but we have a desperate place need to you. The more diverse our care teams are, the better our care is.”
Hopefully the recent surgery won’t be such an unusual occurrence in the future.
“It didn’t really occur to me at the time that an all-female liver transplant was a big deal because I’d seen a lot of all-female transplants in my residency,” Sonnenberg said.
Which prompted Barrett to add, “We know things change quickly. And hopefully this will eventually become just another day at Michigan Medicine.”