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Dr. Charles Rosen was surprised by his Mayo co-workers Thursday with a ceremony to commemorate his completion of 1,000 liver transplants. An athletic jersey with the number 1000 and the board game Operation were among his gifts.

For an affectionate two hours in a modest meeting room on Thursday, dozens of medical workers and Mayo CEO Dr. John Noseworthy gathered to recognize a surgical milestone. Dr. Charles Rosen had recently performed his 1,000th liver transplant.

Colleagues presented the soft-spoken surgeon with a signed pillow in the shape of a liver, a football jersey with the number 1,000, and from well-wishers at the WalMart Centers of Excellence Mayo transplant partnership, the popular Hasbro board game Operation.

"We had this when I was a kid," he said with a laugh. "It kept buzzing all the time."

"This is hardly something a person does alone," said Rosen, who add that the surgery itself "takes four hands" in addition to a broad surgical support team and other medical professionals. The surgeon thanked his transplant center colleagues, the donor procurement system known as Life Source, and "1,000 patients with real need."

"Most important of all," he said, "we should never forget the donors and their families. Although it's always a terrible loss, it's the one good thing that can happen from a tragic situation."

Living donors make up a portion of cases performed at the clinic, as well.

"They are a remarkable group, when you consider the act of undergoing that operation," Rosen said. "It's incredible to think someone can be that generous to someone else."

With the exception of two brief positions elsewhere, Rosen, 55, has been on staff at Mayo since 1991 and conducted all but 160 of the surgeries here. According to United Network for Organ Sharing (UNOS), Mayo Clinic Rochester performed 104 liver transplants last year, 2,478 since UNOS began keeping records in 1988.

UNOS doesn't keep track of individual doctor statistics, but by reaching the 1,000-mark, Rosen likely joins a short list of highly resilient performers in the complex, unpredictable procedure. A modest native of Bismarck, N.D., Rosen, was quick to deflect attention.

"Most of my surgical colleagues are doing difficult, different operations all day long. We are doing one thing every time," he said. That said, Rosen reached the mark by participating in what is arguably one of the most challenging of all surgical procedures, says Dr. Julie Heimbach, a fellow Mayo liver transplant surgeon and colleague.

"On a scale of 1 to 10, it's an 8 or 9 in terms of being on the leading edge of what surgery is capable of doing," Heimbach said. "It's a very technically demanding procedure, it requires full concentration, and it's a physical surgery, usually about four to six hours."

Moreover, liver transplantation is an all-hours, short-notice service.

"You do the surgery when the organ becomes available," Heimberg said. "You work more often in the middle of the night than the day.

"He's incredibly intelligent and hardworking, but also so very dedicated and responsible," she continued. "He's there to help any time of day or night. "

"Dr. Rosen would be the first to tell you that liver transplant is a team sport," said Dr. Brooks Edwards, executive director of the transplant program. "That said, Chuck Rosen is a singularly inspiring individual to watch. Every patient is an individual to him, and he cares for every patient like a member of his own family. He lives the Mayo creed, that the needs of the patient are the only needs to be considered. He's first in to the office in the morning and the last one out at night."

According to the American Liver Foundation, more than 6,000 liver transplants are performed each year in the United States. Nationally, more than 15,000 individuals have been placed on a liver transplant waiting list maintained by the Organ Procurement and Transportation Network.

Cirrhosis or scarring of the liver caused by Hepatitis C is the leading cause for liver transplants in the United States. Other causes include autoimmune disease, alcoholism, genetic illness and medication overdose.

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