{"id":71682,"date":"2023-09-12T09:29:58","date_gmt":"2023-09-12T15:29:58","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=71682"},"modified":"2025-02-28T10:56:34","modified_gmt":"2025-02-28T17:56:34","slug":"regions-first-robotic-liver-transplant-donors-second-gifted-organ","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/regions-first-robotic-liver-transplant-donors-second-gifted-organ\/","title":{"rendered":"Region\u2019s first robotic liver transplant; donor\u2019s second gifted organ"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><figure id=\"attachment_71686\" aria-describedby=\"caption-attachment-71686\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-71686\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/09\/11134141\/UCHealth_DanelKuhlmann00686-web.webp\" alt=\"Kuhlmann, the region's first robotic liver transplant donor, with granddaughters Freya and Ffion. Photo by Cyrus McCrimmon for UCHealth.\" width=\"640\" height=\"448\" \/><figcaption id=\"caption-attachment-71686\" class=\"wp-caption-text\">Danel Kuhlmann with granddaughters Freya and Ffion. Photo by Cyrus McCrimmon, for UCHealth.<\/figcaption><\/figure>\n<p>For Colorado and neighboring states, it was a first.<\/p>\n<p>Never before in the region had a liver-transplant donor surgery been performed by a surgical robot. Given the robotic procedure\u2019s proven advantages in shorter recovery time and fewer complications, the timing couldn\u2019t have been better.<\/p>\n<p>The robotic part was new for Danel Kuhlmann also. But she had donated an organ before.<\/p>\n<p>In 2018, her active, healthy mother had fallen ill and ended up on dialysis for months. She needed a kidney transplant. Kuhlmann, then 49, turned out to be a match. Transplant surgeon, <a href=\"https:\/\/www.uchealth.org\/provider\/thomas-pshak-md\/\">Dr. Thomas Pshak<\/a>, performed the surgery to remove it.<\/p>\n<p>Early on June 9, Pshak was again with Kuhlmann in a <a href=\"https:\/\/www.uchealth.org\/locations\/uchealth-university-of-colorado-hospital-uch\/\">UCHealth University of Colorado Hospital<\/a> operating room. As the bedside surgeon, he would be indispensable to the procedure. But the primary surgeon, Pshak\u2019s colleague <a href=\"https:\/\/www.uchealth.org\/provider\/trevor-nydam-md-ba-surgery\/\">Dr. Trevor Nydam<\/a>, sat at the controls of the <a id=\"\" href=\"https:\/\/www.davincisurgery.com\/\" target=\"_blank\" rel=\"noopener\">Da Vinci Surgical System<\/a> half a room away. Also present was <a href=\"https:\/\/www.uchealth.org\/provider\/elizabeth-pomfret\/\">Dr. Elizabeth Pomfret<\/a>, who leads the University of Colorado School of Medicine\u2019s Division of Transplant Surgery and the <a id=\"\" href=\"https:\/\/medschool.cuanschutz.edu\/surgery\/divisions-centers-affiliates\/transplant\/cctcare#:~:text=Transplant%20Surgery,-About&amp;text=The%20Colorado%20Center,with%20educational%20and%20training%20programs.\" target=\"_blank\" rel=\"noopener\">Colorado Center for Transplantation Care, Research and Education<\/a>.<\/p>\n<p>The surgery would be a team effort. While all three have done many liver transplants. She has more than two decades of experience with live-donor transplants and is expert in the surgery and the various anatomical quirks that can complicate the procedure. Pshak is the UCH transplant-team surgeon with the deepest experience with the Da Vinci system. Among other feats, he performed the state\u2019s first <a href=\"https:\/\/www.uchealth.org\/today\/robotic-kidney-transplant-opens-door-to-patients-with-high-bmi\/\">robotic kidney transplant<\/a>. Nydam, also a robotic-surgery expert, would be taking the lead in what the <a href=\"https:\/\/www.uchealth.org\/services\/transplant-services\/\">UCHealth Transplant team<\/a> hoped would become the prevailing approach to liver-donor surgeries.<\/p>\n<figure id=\"attachment_71687\" aria-describedby=\"caption-attachment-71687\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-71687\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/09\/11134509\/UCHealth_DanelKuhlmann00594-web.webp\" alt=\"Kuhlmann\u2019s recovery time from her altruistic liver donation was cut in half or more thanks to the robotic surgery. UCHealth surgeons see the approach as the future of living liver donation. Photo by Cyrus McCrimmon for UCHealth\" width=\"640\" height=\"479\" \/><figcaption id=\"caption-attachment-71687\" class=\"wp-caption-text\">Danel Kuhlmann\u2019s recovery time from her altruistic liver donation was cut in half or<br \/>more thanks to the robotic surgery. Photo by Cyrus McCrimmon, for UCHealth.<\/figcaption><\/figure>\n<h2><strong>Robotic liver transplants perfected overseas<\/strong><\/h2>\n<p>The first robotic living donor hepatectomy, as it\u2019s technically called, was done at the University of Illinois-Chicago in 2012. Its most experienced practitioners are now a long way from the Windy City. Nydam and Pshak both spent weeks in Riyadh, Saudia Arabia, in late 2022 and early 2023. There they trained on the procedure at King Faisal Specialist Hospital, where surgeons did their first such surgery in late 2018. Since 2021, all living-donor liver transplant surgeries at King Faisal Specialist Hospital \u2013 now several hundred and counting \u2013 have been done robotically.<\/p>\n<p>Necessity played a big role. Cultural and religious factors limit the availability of deceased-donor organs in many Middle Eastern and Asian countries. Saudi Arabia and Korea have emerged as leaders in robotic living donor liver transplantation. In the United States, in contrast, <a id=\"\" href=\"https:\/\/srtr.transplant.hrsa.gov\/ADR\/Chapter?name=Liver&amp;year=2021\" target=\"_blank\" rel=\"noopener\">only about 6%<\/a> of liver transplants involve living donors \u2013 though the percentage is about twice that <a id=\"\" href=\"https:\/\/optn.transplant.hrsa.gov\/data\/view-data-reports\/state-data\/\" target=\"_blank\" rel=\"noopener\">in Colorado<\/a>, where UCHealth surgeons performed about three-quarters of the state\u2019s 176 liver transplants in 2022.<\/p>\n<p>Pshak says University of Colorado is in a great position to follow King Faisal\u2019s lead in transitioning to robotic living donor liver transplant surgery. Studies have shown that the robotic surgery sharply speeds recovery \u2013 two to three weeks rather than six to eight weeks \u2013 thanks to much shorter incisions and lower infection and hernia risk, among other factors.<\/p>\n<p>\u201cIf we could do living donors for livers this way, it would ultimately attract more people to donate with easier recovery and less morbidity,\u201d Pshak said.<\/p>\n<figure id=\"attachment_71689\" aria-describedby=\"caption-attachment-71689\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-71689\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/09\/11134653\/UCHealth_DanelKuhlmann00098-web.webp\" alt=\"Danel Kuhlmann, the region's first robotic transplant surgery donor, pulls granddaughters Ffion, left, and Freya as dog Butter hustles along on Kuhlmann\u2019s property in Parker.\" width=\"640\" height=\"404\" \/><figcaption id=\"caption-attachment-71689\" class=\"wp-caption-text\">Danel Kuhlmann pulls granddaughters Ffion, left, and Freya as dog Butter hustles along on Kuhlmann\u2019s property in Parker. Photo by Cyrus McCrimmon, for UCHealth.<\/figcaption><\/figure>\n<h2><strong>Double donor<\/strong><\/h2>\n<p>But first, they had to attract that first patient. That\u2019s where Danel Kuhlmann came in. Her experiences surrounding her mom\u2019s kidney transplant had been life-changing.<\/p>\n<p>\u201cI was in a desperate position with my mother falling ill. I would have given anything to get her healthy,\u201d Kuhlmann said. \u201cThere was such a sense of despair and just sadness when something like this happens to someone you love. I couldn\u2019t imagine another family being in that position when I had that solution in me.\u201d<\/p>\n<p>So, for the second time, she decided to become a donor. She would give part of her liver to someone who needed it (her liver, which has a remarkable ability to regenerate, would grow back with time).<\/p>\n<figure id=\"attachment_71693\" aria-describedby=\"caption-attachment-71693\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-71693\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/09\/11140106\/UCHealth_DanelKuhlmann00372-web.webp\" alt=\"Kuhlmann, the region's first robotic liver transplant donor, with granddaughters Freya and Ffion. Photo by Cyrus McCrimmon for UCHealth.\" width=\"640\" height=\"462\" \/><figcaption id=\"caption-attachment-71693\" class=\"wp-caption-text\">Danel Kuhlmann with granddaughters Freya and Ffion. Photo by Cyrus McCrimmon, for UCHealth.<\/figcaption><\/figure>\n<p>In late April, a match was identified \u2013 a child. During Kuhlmann\u2019s preoperative appointment on May 25, Nydam broached the subject of robotic surgery. He talked about spending two months training in Saudi Arabia and noted that the procedure brought a quicker recovery with fewer complications. The surgeon produced his phone and shared photos. Kuhlmann was impressed, though she didn\u2019t quite know where he was going with it. Then, she said, \u201cHe popped the question like he was asking to marry me.\u201d<\/p>\n<p>\u201cWill you be willing to be our first robotic liver transplant donor?\u201d Nydam asked.<\/p>\n<p>She said \u201cyes\u201d instinctively, only later wondering if it had been a bit rash. But ultimately, she said, her gut reaction had been the right one.<\/p>\n<figure id=\"attachment_71690\" aria-describedby=\"caption-attachment-71690\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-71690\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/09\/11134853\/UCHealth_DanelKuhlmann00794-web.webp\" alt=\"Danel Kuhlmann agreed to be the region's first robotic liver transplant donor.\" width=\"640\" height=\"429\" \/><figcaption id=\"caption-attachment-71690\" class=\"wp-caption-text\">Danel Kuhlmann agreed to be the region&#8217;s first robotic liver transplant donor. Photo by Cyrus McCrimmon, for UCHealth.<\/figcaption><\/figure>\n<p>\u201cBecause of my familiarity with the team there, I trust them and knew it would go well,\u201d she said.<\/p>\n<h2><strong>Superhuman capabilities<\/strong><\/h2>\n<p>During the procedure, the Da Vinci system sent digital interpretations of Nydam\u2019s hand and foot movements to the surgical robot. The robot removes the natural jitter of even the steadiest human hands, and its steel implements enjoy agility and precision far surpassing those of human limits \u2013 particularly in tight spaces.<\/p>\n<p>The surgeon\u2019s console provided 3-D visualization while monitors around the operating table and high on an operating room wall displayed the proceedings at the same 10X magnification that the system afforded the surgeon. The robot\u2019s three surgical arms and camera needed only half-inch incisions each. The only traditional incision was a roughly four-inch horizontal cut low on the abdomen that was needed to extract a section from the left side of Kuhlmann\u2019s liver.<\/p>\n<p>At the foot of the operation table, Pshak changed out surgical instruments, set up suturing, and, with Pomfret, made suggestions to Nydam during a procedure that took several hours before a small section of liver landed on ice and was whisked across the Anschutz Medical Campus to Children\u2019s Hospital Colorado, where the child\u2019s surgeons awaited it.<\/p>\n<figure id=\"attachment_71691\" aria-describedby=\"caption-attachment-71691\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-71691\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/09\/11135026\/UCHealth_DanelKuhlmann00768-web.webp\" alt=\"Danel Kuhlmann, the region's first robotic liver transplant donor,\" width=\"640\" height=\"419\" \/><figcaption id=\"caption-attachment-71691\" class=\"wp-caption-text\">Danel Kuhlmann, the region&#8217;s first robotic liver transplant donor. Photo by Cyrus McCrimmon, for UCHealth.<\/figcaption><\/figure>\n<h2><strong>\u2018Part of my legacy\u2019<\/strong><\/h2>\n<p>The immediate recovery was, as with any surgery involving anesthesia, \u201crough,\u201d as Kuhlmann put it. But she recovered as quickly as Nydam said she would.<\/p>\n<p>\u201cI would honestly say that between two and three weeks out, I felt 90 to 100 percent back to normal,\u201d she said. By early July, she taking care of granddaughters Ffion, 4, and Freya, 2, which involved a good deal of kid-lifting. As of early August, Kuhlmann says she was entirely back to normal and gardening, hiking, biking, power walking, and running.<\/p>\n<p>She views being a double donor as being \u201cpart of my legacy,\u201d As she put it.<\/p>\n<p>Pshak and colleagues hope robotic surgery makes liver donation a part of others\u2019 legacies too.<\/p>\n<p>\u201cThat she came forward and was willing to give part of her liver to save this child is amazing,\u201d Pshak said. \u201cThis is the way forward to transplant more people and save more lives.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>For Colorado and neighboring states, it was a first. Never before in the region had a liver-transplant donor surgery been performed by a surgical robot. Given the robotic procedure\u2019s proven advantages in shorter recovery time and fewer complications, the timing couldn\u2019t have been better. The robotic part was new for Danel Kuhlmann also. But she [&hellip;]<\/p>\n","protected":false},"author":23,"featured_media":71686,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[3414,3230,9193,39],"class_list":["post-71682","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-kidney-transplants","tag-liver-transplants","tag-robotic-assisted-surgery","tag-transplant-services"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Region\u2019s first robotic liver transplant; donor\u2019s second gifted organ - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Robotic liver transplants, perfected in the Middle East, are now done in Colorado. They offer hope of fewer complications, faster recovery.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.uchealth.org\/today\/regions-first-robotic-liver-transplant-donors-second-gifted-organ\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Region\u2019s first robotic liver transplant; donor\u2019s second gifted organ\" \/>\n<meta property=\"og:description\" content=\"Robotic liver transplants, perfected in the Middle East, are now done in Colorado. They offer hope of fewer complications, faster recovery.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.uchealth.org\/today\/regions-first-robotic-liver-transplant-donors-second-gifted-organ\/\" \/>\n<meta property=\"og:site_name\" content=\"UCHealth Today\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/uchealthorg\/\" \/>\n<meta property=\"article:published_time\" content=\"2023-09-12T15:29:58+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-02-28T17:56:34+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2023\/09\/11134141\/UCHealth_DanelKuhlmann00686-web.jpg\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Todd Neff, for UCHealth\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@uchealth\" \/>\n<meta name=\"twitter:site\" content=\"@uchealth\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Todd Neff, for UCHealth\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/regions-first-robotic-liver-transplant-donors-second-gifted-organ\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/regions-first-robotic-liver-transplant-donors-second-gifted-organ\\\/\"},\"author\":{\"name\":\"Todd Neff, for UCHealth\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#\\\/schema\\\/person\\\/da7733ff5562e48e55c027d111ee5911\"},\"headline\":\"Region\u2019s first robotic liver transplant; donor\u2019s second gifted organ\",\"datePublished\":\"2023-09-12T15:29:58+00:00\",\"dateModified\":\"2025-02-28T17:56:34+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/regions-first-robotic-liver-transplant-donors-second-gifted-organ\\\/\"},\"wordCount\":1294,\"publisher\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/regions-first-robotic-liver-transplant-donors-second-gifted-organ\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2023\\\/09\\\/11134141\\\/UCHealth_DanelKuhlmann00686-web.webp\",\"keywords\":[\"Kidney transplants\",\"Liver transplants\",\"Robotic-assisted surgery\",\"Transplant services\"],\"articleSection\":[\"Innovative care\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/regions-first-robotic-liver-transplant-donors-second-gifted-organ\\\/\",\"url\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/regions-first-robotic-liver-transplant-donors-second-gifted-organ\\\/\",\"name\":\"Region\u2019s first robotic liver transplant; donor\u2019s second gifted organ - UCHealth Today\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/regions-first-robotic-liver-transplant-donors-second-gifted-organ\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/regions-first-robotic-liver-transplant-donors-second-gifted-organ\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2023\\\/09\\\/11134141\\\/UCHealth_DanelKuhlmann00686-web.webp\",\"datePublished\":\"2023-09-12T15:29:58+00:00\",\"dateModified\":\"2025-02-28T17:56:34+00:00\",\"description\":\"Robotic liver transplants, perfected in the Middle East, are now done in Colorado. 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