PHOTO: From left, Shannon Yrigoyen, lead transplant operation nurse, Dr. Assad Hassoun, senior transplant surgeon, Annie Southall, lead liver transplant physician assistant, and Dr. Kidist K. Yimam, transplant hepatologist and medical director of CPMC’s Autoimmune Liver Disease Program, are pictured in Ethiopia.

By Jennifer Modenessi, Vitals contributor

A team of liver transplant specialists from Sutter’s California Pacific Medical Center is improving the lives of patients battling serious liver diseases including liver cancer on the other side of the world.

Dr. Kidist K. Yimam, a transplant hepatologist and the medical director of CPMC’s Autoimmune Liver Disease Program, and colleagues Dr. Assad Hassoun, senior transplant surgeon, Annie Southall, lead liver transplant physician assistant, and Shannon Yrigoyen, lead transplant operation nurse, traveled to Ethiopia in January 2024 on a medical mission to lay the foundation for the country’s first liver transplant program and strengthen a hepatobiliary and pancreatic surgical program at St. Paul’s Hospital Millenium Medical College in Addis Ababa, Ethiopia. The team performed several complex liver and pancreas surgeries, trained liver surgeons and operating room nurses, and donated more than $70,000 worth of medical supplies during the visit to the country’s largest teaching hospital.

Sutter’s CPMC and St. Paul’s surgical teams operate on a patient.

Years in the making, the mission advances much-needed treatment of liver and pancreatic disease in one of the world’s most densely populated countries. According to the non-profit Polaris Observatory, which gathers data about the hepatitis B and C viruses that cause serious liver disease, one person dies every 35 minutes from HBV or HCV infection in Ethiopia. Seventy-five percent of those deaths are attributed to HBC-related liver disease and cancer. “The demand (for care) is huge and urgent,” says Dr. Yimam.

Close to Home

The Ethiopian-born doctor has spent a decade involved in teaching and program development with her colleagues in the gastroenterology and hepatology department at St. Paul’s. The medical center provides care for more than 75% of the country’s at-need, rural community. It’s also home to Ethiopia’s only kidney transplant program, and plans are in motion to develop the country’s first liver transplant center there.

Beyond an extension of her clinical practice, Dr. Yimam’s work in Ethiopia is a way to give back to the community where she grew up.

“As one of four US-trained transplant hepatologists the country has, it was my deep desire and initiative to help create a better liver disease care and transplant program in my home country,” she says.

The lack of a program in Ethiopia has touched her personally. “I have witnessed many people that could have been saved – including my own family members – die from liver failure and liver cancers,” Dr. Yimam says.

Once the program is established at St. Paul’s, surgeons will be able to transplant a section of a living donor’s liver into a patient in the hopes that it will restore the diseased organ’s function to normal.

Journey to Healing

The CPMC team trained operating room nurses at St. Paul’s as part of the medical mission.

Prior to the medical mission, Dr. Yimam began a collaboration with the Ethiopian Health Ministry and St. Paul’s and leading a task force in Africa for the American Association for the Study of Liver Diseases (AASLD). In 2017 and 2018, with support from CPMC and St. Paul’s, Dr. Yimam brought two gastroenterologists and a hepatologist from Ethiopia to train at CPMC’s hepatology department.

Next, she assembled the team of Sutter Health experts to travel to Ethiopia and lend their skills and knowledge. She tapped Dr. Hassoun, who led the creation of a liver transplant program in his native Iraq, and physician assistant Annie Southall and transplant nurse Shannon Yrigoyen. When their trip was delayed by the COVID-19 pandemic, Dr. Yimam and team kept in close touch with their Ethiopian colleagues until they were finally able to travel in January.

At a recent department conference, the team shared details about the medical mission including training medical staff and surgeons with surgical equipment donated by CPMC and Dr. Yimam’s colleague, Joseph Eyuel, a medical supplier involved in non-profit medical work in Ethiopia. The team performed complicated surgeries including a Whipple procedure to treat pancreatic cancer and removed a significant liver mass from a female patient. They also expressed gratitude for having the opportunity to make a difference.

“I really feel like we’re very lucky working in this institution that supports missions like this,” said Dr. Hassoun. “When you help other people in severe need, it’s so gratifying. You get to see that after you’ve done all of this, you’ve made a big impact.”

The work doesn’t stop there. Dr. Yimam plans to keep collaborating with St. Paul’s to further establish its liver transplant program. She hopes to formalize the partnership between CMPC and St. Paul’s and host a multidisciplinary team from St. Paul’s at CPMC this summer. Dr. Yimam also plans to return to Ethiopia early next year with a team that includes an anesthesiologist and a critical care doctor.