Stanley Wright is carefully crafting an emotional letter to a grief-stricken family. He yearns to express his boundless gratitude for their ultimate gift: the liver that gave Wright a new lease on life. “I want the family to know that their loved one lives on,” he says.
As the one-year anniversary of his liver transplant approaches, the 45-year-old Wright recalls a harrowing, two-year odyssey that could have had a very different ending. His journey began in Tuscaloosa, Ala., where the health-conscious power lifter and self-described workaholic visited a gastroenterologist, who told Wright that he suffered from celiac and fatty liver diseases. Within a few months, though, it was clear to Wright that this wasn’t the whole story. Literally overnight, he went from 280 pounds to 465 pounds. “My liver had decompensated and filled my body with fluids,” Wright says. “My fingers looked like sausage rolls and I could barely get my boots on.”
Wright spent 10 days at his local hospital in April 2019. “My skin was leaking like sweat, only it wasn’t sweat,” he says. “From my toes to my head, a corn syrup-like fluid was leaking .” Wright credits a physician’s assistant with connecting the dots and calling a colleague at UAB Medicine. “It wasn’t until I was admitted to the seventh floor of UAB that I first heard the word ‘cirrhosis,’” he says . A lifelong teetotaler, Wright was surprised. “I’ve never smoked, I’ve never drunk, I’ve never done any kind of drugs – just don’t have the taste for it,” he says. “I’ve worked all of my life and never had time to party.”
Although Wright initially wasn’t aware that the tests ordered by UAB Medicine physicians were related to liver transplant eligibility, he quickly understood that the stakes were high. “They told me that there’s a good chance you’ve got an expiration date on you,” Wright remembers. “They were real in telling me that I probably wouldn’t live longer than three years without a transplant.” Wright, who had been conducting online research since the beginning of his journey, discovered that people routinely waited on the transplant list for more than three years.
A LIFESAVING DECISION
Wright sat with that knowledge as his body struggled. An unexpected, gushing nosebleed at a gas station marked the last time he drove. The accumulation of toxins that his liver was unable to filter led to mental fogginess and the inability to multitask. Sheer exhaustion marked an end to sealing the multibillion-dollar transactions that were the hallmark of Wright’s work in the automotive industry. All the while, he continued to undergo medical tests that shuffled his position on the transplant list.
During this ordeal, Wright and his caregiver attended a series of classes at UAB Medicine for transplant candidates. “UAB did a spectacular job,” he says. “There are people I know who were transplanted at different hospitals who weren’t as informed as I was.” The powerful information he received – and his rapidly declining health – led Wright to make a lifesaving decision: to accept the liver of a donor who had tested positive for hepatitis C, a viral infection that attacks and inflames the liver.
Early on the morning of Nov. 15, 2019, after he’d made his funeral arrangements and a day before he was scheduled to go to the hospital to wait for either a liver or death, Wright received the call. “The UAB transplant coordinator told me they had a high-risk liver and that I could be one of the first recipients in their new program,” he says. “I’d already made up my mind that I was going to take it, because hepatitis is treatable.”
According to transplant physician Shikha Mehta, MD, lately there has been an increase in available organs, largely because of the hepatitis C and opioid epidemics that tragically claim the lives of otherwise healthy young people. “Improved therapies for hepatitis C are a major breakthrough that allow us to use these organs, which would otherwise be discarded,” she says. “This offers patients on the transplant waitlist a chance of surviving.”
Dr . Mehta notes that, while the University of Pennsylvania pioneered the transplantation of organs infected with hepatitis C in 2015, UAB has the distinction of being one of the few hospitals that has invested its own resources into the program. “Most programs conduct this type of transplantation under research protocols sponsored by drug companies,” she says. “UAB has promised to work with patients to ensure that the cost of the hepatitis C medication does not limit access to transplantation.”
To date, the UAB Comprehensive Transplant Institute has performed 40 transplants of organs with hepatitis C, including 16 liver transplants. While it’s difficult to quantify shortened wait times due to myriad donor- recipient matching variables, Dr . Mehta says that she’s seen anecdotal evidence of shorter wait times. “This is an additional pool of organs that can be utilized for our patients,” she notes.
UAB’s extensive education process provides transplant candidates with all of their treatment options, as well as the risks and benefits of each. Prior to being placed on the transplant list, UAB obtains a patient’s informed consent. “On the day the organ offer is made, the patient again goes through the process of informed consent,” Dr . Mehta says. “Only when they agree do we proceed with the transplantation.”
That echoes Wright’s experience. “They can offer a hepatitis liver, but you don’t have to take it,” he says. “I figured that, if it didn’t work out, I’d live longer and have a chance to pop back on the wait list.”
Following his surgery, Wright was given medicine to clear his new liver of hepatitis C, along with the medications typically given to transplant patients. “I tested negative by the time I was discharged, though I continued to take the medication for 12 weeks,” he says. Dr . Mehta notes that the treatment is one drug, twice per day for 8-12 weeks. “Survival is excellent for these patients,” she says. “We haven’t observed any complications from hepatitis treatment in our patient population.”
Wright, like every transplant patient, has had a grueling but rewarding road to recovery. Saying he was “fileted like a fish with a hip-to-hip incision,” Wright has taken endless blood draws, physical therapy, and leaky drains in stride. “I was 100 percent positive,” he recalls. “I had 100 percent faith in myself, God, and the doctors.”
PROMOTING ORGAN DONATION
Understandably, both Wright and Dr . Mehta are vocal advocates of organ donation. “There are more than 110,000 patients waiting for a lifesaving organ, including 12,000 waiting for a liver transplant,” Dr . Mehta says. “Twenty people die each day waiting for an organ.” While some believe that those with acute or chronic hepatitis B or C aren’t allowed to be organ donors, Dr . Mehta says that’s simply not true. “There is a great need for organ donation, and over 1,000 such organs are safely transplanted every year,” she says. “Imminent death can be avoided.”
Wright is tackling organ donation on two fronts: the personal and the political. “Every time I interact with someone, I ask if they’re an organ donor,” he says. “One donor can save eight lives, and you can fill a football stadium three times with people needing a liver .” He also advocates for change in the way organ donations are handled. “We should have a system where you’re automatically enrolled as an organ donor and have to actively opt out, instead of the other way around.”
Wright soon will have his final stent removed, calling that day “my official graduation.” Then he’ll put the finishing touches on his letter to his donor’s family, thanking them for their generosity in giving him the gift of life.
Source: UAB News