Two Prominent Nebraska Doctors Become Patients In Living Donor Liver Transplant
Omaha, Neb - As the State of Nebraska's Chief Medical Officer, Joann Schaefer, M.D. knows a great deal about large-scale public health issues. The same goes for Gary Gorby, M.D., the Chief of Infectious Diseases at Creighton University Medical Center. Right now, both physicians are focusing on the big job of recovering as patients themselves.
Dr. Schaefer, 40, said she has known for several years the need for a liver transplant may arise. In the last several months it did.
"In three months, I went from being extremely healthy to this," Dr. Schaefer said before the transplant. "Then eight weeks ago, I realized something was not quite right."
Her liver disorder caused cirrhosis, or scarring of the liver. That condition created portal hypertension, a condition that caused serious complications for Dr. Schaefer including fatigue, bleeding and fluid retention.
"Her condition was most likely inherited," said Michael Sorrell, M.D., gastroenterologist and co-founder of the liver transplant program at The Nebraska Medical Center. "Dr. Schaefer's grandmother had died from liver disease in her 50s," Dr. Sorrell said.
"My doctor said it's time for a transplant, my quality of life was not going to get better," said Dr. Schaefer.
She did not have to look far for a donor, at least nine family members and friends volunteered. Dr. Schaefer jokingly called it her "lucky lobe search," referring to the left or right lobe of the donor's liver that would be transplanted into her body.
Neighbor, friend and fellow physician Dr. Gary Gorby was a match. "I've known for sometime she was going to need a transplant," said Dr. Gorby. "I knew our blood types matched. I also knew she wouldn't be high on the list for a cadaver donor. You don't get the opportunity very often to save a friend's life."
Liver transplants from living donors are a relatively new medical procedure. Although kidneys have been transplanted from living donors since 1954, the first adult to adult living liver transplant didn't take place until 1997.
"The operation is becoming more common because the demand for livers far outpaces the number of organs from deceased donors," said Alan Langnas, D.O., Chief of Transplantation at The Nebraska Medical Center and Professor of Surgery at UNMC. "Living donor transplants have great potential for changing the face of liver transplantation in the future."
On Monday, March 31, two transplant teams prepped for two simultaneous surgeries at The Nebraska Medical Center. Dr. Langnas removed the diseased liver from Dr. Schaefer, while at the same time the donor's transplant surgeon, Debra Sudan, M.D., removed approximately half of Dr. Gorby's liver. Both surgeons then worked together to transplant the portion of Dr. Gorby's liver into Dr. Schaefer's body.
"The normal size for the liver is about one percent of a person's body mass," Dr. Sudan explained. "That's the target size for the transplant liver in order to optimize early liver function and its ability to regenerate."
Dr. Sudan added that the liver is unique in this trait. "The size increases as much as 100 percent in both donor and recipient, often within six to 12 weeks."
For major surgery, the risks for a liver donor are relatively low. The typical operation runs a 10 percent chance of complications and less than 1 percent chance of death, said Dr. Sudan.
Even with the risks associated with the transplant, Dr. Gorby felt the chance to help a friend outweighed the risk. "I know it's a big surgery - it's not a hangnail," said Dr. Gorby before the transplant. "I have realistic anxiety. I expect it'll hurt, but I expect it'll go well."
For the recipient, the most serious complications are rare, but can occur if the new liver does not function properly or if blood vessels develop clots.
"Liver transplant recipients can also develop infections or rejection of the new liver, but these conditions are usually easily controlled with medication," said Dr. Langnas.
"There are significant advantages to receiving an organ from a living donor. The surgery can be planned to occur when the recipient is healthy instead of waiting until the disease is in its advanced stages," added Dr. Langnas. "The living donor organs in general function better than deceased donor organs."
After a more than a week recovering from the surgeries, both Dr. Gorby and Dr. Schaefer said they felt strong and both went home from the hospital.
"I could tell a difference right away," Dr. Schaefer said after the transplant. "I feel stupendous."
Both physicians plan to spend at least two months recovering from surgery before returning to work.
Dr. Schaefer hoped by making her story public, she would inspire more people to become organ donors. Nationally, more than 98,000 people await organ transplants. Two days after the transplant, Dr. Schaefer said she had received e-mails from people who said her transplant had inspired them to become donors.
"If one person marks their drivers' license to become a donor after hearing about it, then it's all worth it," she said.
Dr. Gorby heard similar remarks even before the transplant. "People would say, 'It makes me want to be a better person.' If this gets other people thinking about becoming donors, that's great to hear."
With a reputation for excellence, innovation and extraordinary patient care, The Nebraska Medical Center has earned J.D. Power and Associates' Hospital of Distinction award for inpatient services for three consecutive years. It also received the 2007 Consumer Choice Award, a mark of patient satisfaction as selected by healthcare consumers and has achieved Magnet recognition status for nursing excellence, Thomson 100 Top Hospitals Performance Improvement Leader recognition, as well as the Award of Progress from the state of Nebraska's Edgerton Quality Awards Program. As the teaching hospital for the University of Nebraska Medical Center, this 689 licensed bed academic medical center has an international reputation for providing solid organ and bone marrow transplantation services and is well known nationally and regionally for its oncology, neurology and cardiology programs. The Nebraska Medical Center can be found online at www.nebraskamed.com.
UNMC is the only public health science center in the state. Its educational programs are responsible for training more health professionals practicing in Nebraska than any other institution. Through its commitment to education, research, patient care and outreach, UNMC has established itself as one of the country's leading centers in cancer, transplantation biology, bioterrorism preparedness, neurodegenerative diseases, cardiovascular diseases, genetics, biomedical technology and ophthalmology. UNMC's research funding from external sources is now nearly $80 million annually and has resulted in the creation of more than 2,400 highly skilled jobs in the state. UNMC's physician practice group, UNMC Physicians, includes more than 460 physicians in 50 specialties and subspecialties. They practice primarily in The Nebraska Medical Center, UNMC's teaching hospital. For more information, go to UNMC's Web site at www.unmc.edu.Back to Top