An excerpt from “The Overlooked Organ” by Anissa Anderson Orr.
It was the fall of 2015 when Jeff Lake had his first inkling something was wrong. The normally energetic husband and father of twin teenage girls couldn’t sleep at night. He started taking naps. And he began gaining weight, so much so that a pair of pants bought in October wouldn’t button closed in November.
By December Jeff looked and felt terrible. He pushed his worrisome symptoms to the back of his mind. But they wouldn’t be ignored much longer.
Crushing chest pains rocked Jeff awake early in the morning of Dec. 22. Gasping for breath, he woke his wife, Deborah, and asked her to call 9-1-1. EMS took him to his local hospital. “I thought I was having a heart attack,” Jeff says.
He wasn’t. But another vital organ was in trouble: his liver.
“The doctor told us Jeff had liver failure,” says Deborah, media relations manager for McGovern Medical School at UTHealth. “And that began this whole journey. We learned he had a life-threatening illness, and if it was not fixed, he would die within a couple of years.”
Like Jeff, many of us don’t think about our livers much. But this football-shaped organ, the largest solid organ in the body, plays a critical role in our health. It converts what we eat and drink into nutrients, filters toxic substances from the blood and helps control the body’s metabolism. A healthy liver has the remarkable ability to regenerate, if the damage is caught early.
“When people think of someone with liver disease, their first inclination is to think that he or she must be a drinker, or have Hepatitis C. There’s a stigma to it. But in reality, nonalcoholic fatty liver disease affects a substantial part of the population, and is growing into a potentially huge public health burden,” said Dr. Wasim Dar, transplant surgeon at Memorial Hermann-Texas Medical Center and McGovern Medical School.
Chronic liver disease slowly, and silently, ravages the organ over a period of years, without symptoms. So patients don’t know to make lifestyle changes, or seek treatment until it is too late. When large parts become damaged or scarred, a condition called cirrhosis, the liver can’t do its job. Eventually it just quits. This is called liver failure. And it is a life-threatening emergency. In many cases, a liver transplant is the only cure.
Traditionally, Hepatitis B and C and long-term alcohol consumption have been the leading causes of liver failure in adults. But a condition called NASH (Nonalcoholic Steatohepatitis), a severe form of non-alcoholic fatty liver disease, is making a startling impact.
NASH occurs when too much fat builds up in liver cells, inflaming and damaging the liver. While new treatments have helped reduce cases of Hepatitis C, cases of non-alcoholic fatty liver disease and NASH are climbing as more Americans develop obesity, diabetes and high cholesterol.
By the time Jeff was diagnosed with liver disease, years of unhealthy habits, combined with diabetes and high blood pressure, had destroyed his liver. Deborah had Jeff transferred to Memorial Hermann Transplant Center at Memorial Hermann-TMC.
He arrived thin and jaundiced. His beard had turned gray, and he had “a belly-full” of ascites or pockets of extra fluid in his abdomen. In the first two weeks of his treatment, Jeff had more than 20 pounds of fluid drained. That fluid had partially collapsed one of his lungs, creating his initial heart-attack-like symptoms.
“It was pretty evident from our first interaction that he would need a liver transplant,” said Dr. Moises I. Nevah Rubin, gastroenterologist at Memorial Hermann-TMC and McGovern Medical School. “Without one, he would have probably been expected to live from three to nine months at the maximum.”
Jeff was placed on the transplant list in early May 2016, but he learned that the wait could be about nine months. As they drove home from the clinic visit, Jeff and Deborah mentally prepared themselves for the long haul. Then, just blocks away from the Texas Medical Center, they got the call. It was 3:30 p.m.
“The transplant coordinator said, ‘We have an offer. Turn the car around,’” Deborah recalled. She and Jeff were in shock. “I asked her, ‘Is this a drill?’”
She assured them it was not. The Lakes quickly returned to Memorial Hermann-TMC, Deborah still in her work clothes, which she would wear for three days. The donor organ was on a plane to Houston. This was happening now.
By 6:30 p.m., Jeff was in surgery. Over the next five hours, transplant surgeons Dr. Dar and Dr. J. Steve Bynon, chief of abdominal transplantation at Memorial Hermann-TMC, worked together with their highly skilled transplant team.
They cut a curved, horizontal incision in Jeff’s abdomen, just under the ribs, and removed his diseased liver — carefully disconnecting it from the diaphragm and major blood vessels. Next, they inserted the new liver and methodically connected the blood vessels, restoring blood flow throughout Jeff’s body. Finally, they linked Jeff’s bile duct system to his new liver. Would the bile flow? Yes. They closed his incision. Success.
As he recovered, Jeff looked for signs that his new liver was working. A few days after surgery, the whites of his eyes were white again. Then his skin lost its yellow tinge and returned to its normal, ruddy complexion. “On the Friday after surgery, I had a photo taken of me and my two daughters,” he said. “I was blown away by how red my beard was. That was a huge thing.”
Jeff returned home after just a week in the hospital. He continues to improve every day. Jeff is learning new habits and making lifestyle changes to keep his new liver healthy. He is committed to honoring the gift of life he received from his donor and living life to the fullest. That means spending time with the ones he loves — Deborah and his daughters, Savannah and Courtney.
“Most people don’t get a second chance at life. I was given it,” Jeff said. “This is my second shot at it. I am going to get it right.”