David's Miracle

Kim's brother, Dave, has been sick with non-alcoholic cirrhosis of the liver.  He started going downhill about May when he began retaining large amounts of fluid, became extremely fatigued, and started becoming slow when responding to questions.  Of course these symptoms appeared slowly, so we didn't notice just how extreme his symptoms were.  He got to the point where he literally would be too exhausted to walk up a flight of stairs and would often fall asleep during a conversation.  He started having paracentesis performed where they would draw off approximately 6 liters of fluid.  The day before the Olsen family party he had to have 10 liters drawn off.  Two days later his kidneys started failing and he was admitted to the ICU in Ogden where they were able to get him stabilized.  

According to Sutter Health the Model for End-Stage Liver Disease (MELD) system is used to prioritize patients waiting for a liver transplant. The range is from 6 (less ill) to 40 (gravely ill). The individual score determines how urgently a patient needs a liver transplant within the next three months. The number is calculated using the most recent laboratory tests. In general, a donor is matched to a potential recipient on the basis of several factors: ABO blood type, body size, degree of medical urgency and MELD score (Model for End-Stage Liver Disease).   United Network for Organ Sharing (UNOS) uses a computerized point system to distribute organs in a fair manner. Recipients are chosen primarily on the basis of medical urgency within each ABO blood group. Waiting time is only a factor when patients have the same MELD score.

David’s Meld score was about 25, he was told that he would need to be over 28 to be considered for a liver transplant.  He was finally transported to the University of Utah hospital to make preparations and help him get more “healthy” as he got sicker to help him be ready for the time a transplant became necessary.  Then a shock, the doctor at the U told him his MELD score would need to be around 35 in order to get a transplant.  A feeding tube was placed and he was being prepared to be sent home to wait. 

Currently, the average MELD score for a patient undergoing a liver transplant is 20 nationally. The average MELD score for liver transplant patients in the western region varies from 26-33, depending on blood type.

The average waiting time for a patient to receive a liver in our region, once a patient is placed on the UNOS waiting list, is 12-36 months. This waiting time may be very short for a patient with very high MELD scores and especially those with acute liver failure.

Waiting time varies according to blood type, e.g. patients with O blood type wait longer on average, and patients with B, A & AB blood type wait a shorter period of time. The severity of a patient’s liver disease and any contributing medical illnesses, such as kidney failure and/or liver cancer, may result in a patient receiving a higher MELD score. As a patient’s MELD score increases, the priority to receive a liver transplant increases. If a patient’s condition improves, and the MELD score decreases, the priority to receive a liver transplant decreases.

Then a true miracle occurred.  The very next morning David’s wife, Alicia, received a phone call that said that David was going to go to surgery – that day – for a transplant!  Apparently that morning a liver became available and the person before Dave needed both a liver and a kidney, which was not available.  And just like that, Dave got his new liver!  It was truly a miracle!

After the surgery the surgeon told Alicia that Dave’s liver was much worse than they had thought and it was a good thing that a transplant was able to be performed.  The doctor also said that Dave lost approximately 50 lbs of fluid during the surgery!

Dave has a long recovery ahead of him, but at least he has the option of getting better. 

What a miracle!