Liver Transplant
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At the UVA Transplant Center, we’ve performed more than 1,400 liver transplants since our program started in 1988. We were the first Medicare-approved liver transplant center in Virginia.
Our transplant recipients include patients from all over Virginia. We also specialize in both out-of-state and international patients with particularly challenging cases. We care for patients who are awaiting liver transplant through medical management and state-of-the-art imaging and drug therapy, which can improve survival after transplant.
Liver Transplant Support Group
Join both pre and post-liver transplant patients for information, discussion and support.
From Liver Transplant to Marathon
Steve received his liver transplant in the spring of 2016. In October of 2017, Steve ran the Marine Corps Marathon.
Steve Nugent: I was 38, and I was going to get some life insurance, because we were expecting another baby. And when I went to get the insurance, they did some blood work on me. And it came back, and the guy said, I'm not going to give you life insurance. And I suggest you go to a doctor immediately, because there's something wrong with your liver. And so sure enough, he came in the room and said, hey, I hate to tell you this, but you're really unlucky. There's a good chance in the next four or five years you're going to need a transplant.
Diane Nugent: He was miserable. He was just miserable.
Steve Nugent: When the bile backs up into your liver, and it's not getting out, what happens is that bile gets into your bloodstream. And so you get the worst itching you could ever imagine, 10 times worse than poison ivy or anything like that, and it's everywhere. You're just really super tired. So I'd go from feeling OK to a blockage and then all this itching would come in. And my eyes would go yellow. My skin would go yellow. And you get very confused what's happening.
Daniel Maluf, MD: So when we met Steve, he came for a second opinion type. And he already has a liver transplant, so he has the experience in liver transplant. And he was in a stage of his liver disease. Post-transplant, he was malnourished. He was debilitated, and he was in jaundiced, meaning he was a little bit yellow in the skin. So he looked kind of deteriorated when we met him.
Steve Nugent: I was laying in bed. It was hard for me to get out anymore. She said, what do you want? I don't want to leave you guys, but I can't do this anymore. And she said, give me two more weeks.
Cynthia Williams, RN: He didn't have a choice. The liver he had received in his first transplant had shut down. It was causing kidney problems, digestion problems. His only option was to be re-transplanted.
Diane Nugent: Sometime in May is when we had our evaluation, and we were transplanted 31 days later.
Steve Nugent: Well, my first memory of waking up was this big hot blanket on me and somebody going, I'm giving you a bear hug. But I quickly knew that, hey, what I was waiting for had happened. And right now, I'm alive.
Diane Nugent: When they took the tube out, and he literally looked at me, and he's like, I'm running the Marine Corps Marathon. I go, I know you are. But let's just focus on getting through this right now. He's like, no, I'm going to just make sure a transplant's OK with it, but I really want to do this.
Cynthia Williams, RN: It just attests to his total passion for accomplishing things.
Steve Nugent: When you're sick, and you're just trying to hold on, you lose all hope, and you lose all dreams. UVA gave me hope because they said, I'll find you an organ.
Daniel Maluf, MD: When I learned that Steve was running this marathon, I couldn't believe it, because he run it a few months after the transplant. So I was very impressed by the degree of recovery that Steve achieved.
Steve Nugent: Cindy, if there's a more positive person in the world, I'd like to meet her, because Cindy is all about-- it's going to work. It's going to go.
Diane Nugent: They were there. They comforted you. They gave you support. They gave you strength. They just made you feel like you were in a place where they truly, truly cared. And they do.
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Liver Research
Our hepatitis research programs are among the most comprehensive in the nation and have received international recognition. They include studies of Hepatitis B and C and ways to prevent and treat these conditions in transplant patients.
At UVA, we've been involved in the study of patients undergoing living donor liver transplant, as well as transplants in HIV positive patients with liver disease.
Living Donor Transplants
We are one of the few sites in the nation to offer this life-saving form of liver transplant. In 2002, our center was selected by the National Institute of Health to become one of 10 sites in the country to study this procedure. Learn more about the benefits of living donor liver transplants.
Ending Cancer With a Liver Transplant
"From the moment that I met the team, I instantly felt a connection to them. They left me feeling a sense of hope,” Leslie says about the UVA team that transplanted her liver.
Leslie Waller: It felt as if I literally got punched in the abdominal area.
Narrator: Abdominal pain, Leslie Waller knew something was wrong.
Waller: It impacted the way that I walked. I almost had to hunch over to feel comfortable.
Narrator: She visited her doctor but couldn't get any real answers, only warnings.
Waller: He said, make sure you don't leave this alone. Please make sure you take the time to continue, to have more tests done. Don't leave this alone.
Narrator: Leslie's questions about the source of her deteriorating health were answered in April of 2013 by a new doctor.
Shawn Pelletier, MD: She was diagnosed with hepatic epithelial hemangioendothelioma.
Narrator: That's a cancer that affects only one in one million people.
Waller: It's almost like an out-of-body experience. It feels surreal. You just take that moment, and you pause, because it's definitely not something you expected. And that word can be a very scary word.
Narrator: She had to get past her fear.
Waller: You know what, Leslie? It's cancer. But we need to move forward. What are we going to do about it?
Narrator: According to her doctors, there was only one way the then 33-year-old could move forward.
Waller: In terms of prolonging life, he said, you need to consider having a transplant.
Pelletier: The tough decision was for her, if she did nothing, she might live for 20 years and then have problems with the tumor down the road. Or if she gets a liver transplant, she might be cured. But on the other hand, she could have a complication from the surgery and die within the next year.
Narrator: UVA Medical Center's Transplant Department guides patients in making that decision.
Pelletier: Right now, we have a little over 120 patients on our waiting list, and we transplant about 60 per year.
Melissa Donovan,RN: Your rank on the list depends on your acuity of your illness. So essentially, the sicker you are, the higher on the list you're going to be.
Narrator: Another option is to find a living donor who's organ can patch up failing ones.
Pelletier: The operation is a lot harder, and then also that the person who's donating is also taking the risk of having complications from the surgery as well.
Donovan: You actually take a piece of the liver out, and you put it into the recipient. And both of those regenerate. Both of those livers regenerate within weeks to months.
Narrator: Either path patients choose, donors have to be vetted.
Pelletier: For the most part, all we need is a blood type that's compatible with the recipient. Size does matter a little bit, if the liver is too big or too small.
Narrator: Depending on someone's diagnosis, the waiting game of transplant can have a harsh reality.
Donovan: We can get them so far, but if that organ doesn't become available for them in the time that they need it, then they end up dying.
Narrator: In Leslie Waller's case, she was a universal accepter, which meant her blood type was compatible with any type of donor.
Waller: Not only do I have a rare diagnosis, but I have a rare blood type. And in most cases, most people are universal donors. I was a universal accepter. What are the chances?
Narrator: A full liver transplant required Waller to prepare for weeks.
Pelletier: People come in, and they think they're going to have a doctor's visit for 30 minutes, get put on the list, and go from there. And really, the process, we start out with a two full days of evaluation.
Donovan: They meet all the members initially. They meet the surgeon. They meet their transplant coordinator. They meet a nutritionist, a pharmacist. They meet our specialized financial coordinators.
Quincy: We had a plan, just like you have a fire route.
Narrator: Quincy and Leslie prepared as much at home as in the hospital.
Waller: I meticulously organized it and had it ready to go.
Narrator: Then waited. Good news came in September 2013.
Waller: I couldn't believe I was getting this call.
Donovan: It never gets old to be able to call a patient and say that we have an organ available for them. It always gives me a chill down my spine before I pick up that phone to call them.
Narrator: Almost two months after being listed, a new liver was on its way to Leslie.
Pelletier: On average, the liver is out of the body without blood flow sitting on ice for about eight hours.
Narrator: A few hours of surgery later, and the first thing to come to Leslie's mind was bittersweet.
Waller: I felt blessed because I've been given an opportunity to extend my life. But at the same time, I knew a family was grieving. And so I woke up, and that was one of my first thoughts. I was thinking about the family.
Narrator: At UVA, the identity of the organ donor is confidential. Doctors say the five months from diagnosis to surgery in Leslie's case is not common. But wait time on any organ transplant list depends on each individual patient's condition.
Pelletier: For people who have cancer, kind of the routine is that we can actually get extra points to move them off the list. Because even though they might not die from their liver failure in the near future, if their cancer grows and spreads, then they lose the potential to get a transplant.
Waller: Well, it wasn't that long of a wait in the grand scheme of things. But while you're going through it, it feels like it's an eternity. No, no, no, no.
Narrator: Now, a year and a half after surgery, Waller knows her life will never be the same.
Waller: I have to take medication every 12 hours on the hour.
Narrator: But she's determined to live the life her donor gave her to the fullest.
Waller: Yes, I have to take medicine. But the fact that I can wake up each day, I'll take that medicine twice a day, three times a day, four times a day. You want me to run a mile? I'm going to run a mile. Don't sweat the small things in life and enjoy the small things that you probably wouldn't have enjoyed before.
Narrator: [INAUDIBLE] Amber, NBC 29, HD News.