Living-donor liver transplant a success

Ronda Heil was sick and she needed a liver. Hers was failing. And without one, she was going to die.

The stubborn Heil had been waiting for a liver from a deceased donor for more than a year. None was in sight. So her sister Sarah Gardner gave two-thirds of her own liver to Heil, whose liver was cut out to make room for the partial organ.

It was a sisterly gift of life; the two women underwent their rare and risky living donor liver transplant surgery at the Mayo Clinic in mid-September. Today they are recovered, their livers regenerated to normal size, and are getting their lives back on track.

Emerging from a two-year ordeal full of scares, a heavy weight has been lifted from the shoulders of the two women and the shoulders of their supportive husbands and children and family and friends.

“We’re just relieved it’s over,” said Gardner, 42, of Kalispell. “Everybody’s fears have been calmed and everything turned out great.”

Gardner said she knew things would work out after she got a blessing at church. But it wasn’t always so clear for everyone else.

Heil’s liver was already failing in summer 2010, she just didn’t know. She went to the doctor and complained about itchy skin, bumps under her eyes, fatigue and spotty color changes on her skin.

The doctor asked to do some blood work and found Heil’s liver enzymes were off the charts.

Heil, who turned 45 in July and lives in Columbia Falls, was diagnosed with primary biliary cirrhosis. The mysterious disease makes the body’s immune system attack and over time destroy the liver.

A liver expert in Kalispell did a biopsy and gave Heil about two years to live.

“He thought maybe I would be in the first or second stage. But it was pretty much at the last stage,” she said.

The estimate proved accurate.

Last year, Heil was hospitalized and almost died because of internal bleeding from her liver. She was sent to the Mayo Clinic in Rochester, Minn., and put on a long list of people waiting for a liver from a deceased donor. That’s no guarantee a person gets one.

“There’s 7,000 people who needed a liver and 6,000 people got one last year,” Heil said about the transplant list. “So there’s lots of people that need livers and don’t get them.”

By this spring, Heil was back in the hospital. Her liver and her spleen were so swollen she could scarcely breathe. She felt searing pain with every breath as her diaphragm pushed against them. To complicate things, she caught pneumonia.

Heil was running out of time. With no donor liver in sight, her two sisters, Sarah and Dawn, hatched an idea to volunteer their own.

“SHE WAS getting greener and greener by the day,” Gardner said of Heil’s failing health and unwillingness to go along with the idea. “She had to get dragged along with it, but by that point she was too sick to argue or fight with anybody.”

That set off a long series of intensive questioning and medical screening to see if either sister was a suitable donor.

Dawn was ruled out. Dawn’s liver wasn’t big enough to give Heil what she needed and leave her with enough. The Mayo Clinic won’t perform a liver transplant if more than 70 percent of the living donor’s liver needs to be taken.

Gardner had to give up 68 percent of hers.

Gardner got a go-ahead from the Mayo Clinic in July. The transplant was scheduled for early August but had to be postponed multiple times as more and more testing was needed for the surgery to proceed.

“Liver donation transplant surgery is one of the most difficult things they do, because you are taking a healthy person and making them very sick,” Gardner said. “They do at least 3,000 kidney transplants a year, but I was the 140th [liver donation] case in 10 years. So that tells you how often it takes place and how serious they take it.”

With the transplant set for early September, Mayo Clinic flagged some atypical tissue detected in one of Gardner’s breasts. She had to undergo surgery to have the tissue taken out. That showed it was not cancerous, but delayed the transplant two more weeks.

A few days before the rescheduled transplant, one final test found Gardner had elevated liver enzymes.

That could have been caused by something as simple as a harmless virus or something she had eaten, but Mayo Clinic wanted to postpone the transplant for one month. But after multiple trips to and from Rochester, Gardner pushed to just stay there through the weekend and test again Monday. That worked. Her enzyme levels had fallen and the transplant could proceed.

The surgery went well, followed by six weeks of recovery.

Heil’s body tried to reject the donated liver after a week. Doctors stopped that with powerful steroids, but are still working to fine-tune her medication to keep the liver from being rejected. That’s going to be a lifelong challenge going forward.

But as Heil prepares to return to work in January, her biggest fear has passed: Her sister Sarah is doing fine.

Gardner split a few stitches and caught an infection by pushing her recovery.

“I had been gone so long I felt like I needed to show up at a few of my kids’ functions, when I was probably supposed to be in bed,” she said.

News of that post-surgery infection threw Heil into a tizzy at the time, but doctors quickly got it under control. “I was hysterical when she called me,” Heil said. “That was my biggest fear, that something was going to happen to her.”

But Gardner is back on her feet. She started jogging again this week and is back at Flathead Valley Community College where she’s studying to be a nurse.

“I’m doing great,” Gardner said. “And my sister’s not yellow or green any more ... Life is good.”

Heil’s feeling a lot better, too. She just has a hard time holding back the tears whenever she looks at her sister. “I’m just so thankful. I’ve never been so thankful in my entire life,” she said of the gift.

The story

A nursing student, Gardner will share her liver transplant story during the annual Scholar’s Conference at Flathead Valley Community College on Friday, Dec. 7.

The conference starts at 12:30 p.m. in the Arts and Technology Building. Gardner is scheduled to speak at 2:30 p.m.

Reporter Tom Lotshaw may be reached at 758-4483 or by email at tlotshaw@dailyinterlake.com.