Liver recipients doing well as UF transplant program returns to full speed


Liver transplant patient Jessica Carroll, 16, shown looking at an image of herself during surgery, attends a follow-up appointment with her mother, Susan Carroll, right, in the Transplant Surgery Division at Shands at UF in Gainesville, Fla., Monday, April 22, 2013.

Erica Brough/Gainesville Sun
Published: Thursday, April 25, 2013 at 6:01 a.m.
Last Modified: Wednesday, April 24, 2013 at 5:23 p.m.

Jessica Carroll's eyes looked yellow.

The 16-year-old from Clermont, Florida, had had a stomach ache for a few days around Thanksgiving, but it wasn't until she saw her eyes that she worried. On the Internet, she learned that liver troubles could cause a yellowing of the eyes and skin.

And indeed, her liver was troubled: Unable to metabolize copper because of a genetic condition called Wilson's disease, the buildup of copper in her body over her lifetime had left the organ pock-marked and essentially dead. It was on its way to poisoning her eyes and brain by the time the teenager reached the University of Florida at Shands.

Six days later, when Carroll was hours from death, a donor liver was found.

“They pulled her father and I back, and her father started saying that we have a DNR (Do Not Resuscitate), and the doctor said, ‘OK, that's nice, but we have a liver,'” said Jessica's mother, Susan Carroll.

The severity of Carroll's case had bumped her to the top of the region's donor waiting list, and once the doctors received word that the liver of a 15-year-old boy was a match, the long but swiftly moving process of getting the donor liver, prepping it and bringing it back for transplant had begun.

On Monday, Carroll was one of three liver transplant patients (the other two were babies) back at UF at Shands for a followup visit. These three were the first liver transplants -- all successful -- done at the hospital since the transplant program reopened last fall after about a year-long closure because of a loss of personnel.

“The program is growing back,” said Dr. Jeffrey Fair, chief of UF's division of transplantation. Fair added that there is going to be greater emphasis on building up the pediatric transplant division moving forward. Shands is one of only three transplant centers in the region that do pediatric transplants -- the two others being the Miami Transplant Institute and Emory University in Atlanta, he said.

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On Monday, Carroll, with her waist-length chestnut brown hair and green nail polish, and her best friend Hannah by her side, seemed like any other high school junior. She said she had resumed her job at the TJ Maxx clothing store and was caught up with her classes.

But scrolling through her phone she found a photo of herself lying in her hospital bed, with orange-yellow skin and bloated -- like “an Oompa Loompa” Susan Carroll said, adding,

“I keep telling people that she was my Christmas Miracle.”

Jessica is now more determined than ever to become a doctor -- a transplant surgeon. “I always wanted to be a doctor, but this solidified what I wanted to do,” she said.

In the examining room next door, 16-month-old Chelsey Hoyle crooned in her stroller like the happy baby she has become since her first birthday in early December. That's when she was released from the hospital following her liver transplant.

Slightly smaller than average for her age, she is just beginning to catch up to her peers.

Born with biliary atresia, a life-threatening condition in which infants' bile ducts don't have openings inside or outside the liver, Chelsey was two weeks old when she started to turn yellow, the first sign of the fatal condition.

Fair described her diseased as “like a little knot.”

“You could have used it for a baseball,” he said.

Like Carroll, Chelsey was far up on the transplant list for about a week before receiving a donor liver -- from an adult.

“The liver was about the size she was,” Fair said, explaining that he clipped just one part of the adult donor's liver to sew into Hoyle. The liver will grow as Chelsey does, eventually becoming full-sized.

The delicate eight-hour procedure and her recovery went well, Fair added. “She sailed actually.”

Chelsey's mother, Kaylee, said that during those hours, she was both stressed out and excited.

“I was finally going to have a healthy baby,” she said. But she wanted to preserve some of what her daughter had been through -- including a blood clot in her portal vein -- in her baby book.

Fair said that both Chelsey and Carroll will need to monitor their livers for a long time as the new organs become part of their own bodies.

“They grow into (the liver), and then it grows into them.”

Contact Kristine Crane at 338-3119, or kristine.crane@gvillesun.com.

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