Newswise — At any given moment more than 98,000 people in this country are waiting for lifesaving organ transplants and many more wait for donated tissues. On average, 17 people die every day—6,600 each year—waiting for an organ transplant. Many die before organs become available.
David Gitlitz of Kingston, 65, a long-time professor of Spanish at the University of Rhode Island is one of the lucky ones. Seven people offered to share their liver with him.
But let's start at the beginning. Gitlitz has been Alpha-1 antitrypsin deficient since birth, thanks to an unwelcome confluence of family genes.
Alpha-1 attacks the liver and/or lungs. While it may eat away silently and undetected for decades, eventually it makes itself known.
Gitlitz found out he had the condition a dozen years ago when he had an emergency appendectomy. While in the abdominal neighborhood, the doctor took a look at his liver and recommended that Gitlitz see a pulmonary specialist who was also an Alpha 1 specialist.
By last year, Alpha-1 had destroyed about 10 percent of Gitlitz's lung capacity, essentially through emphysema, and nearly all of his liver. His ability to function was severely limited. The best chance he had for survival was a liver from a live donor.
That's when Daniel Carpenter, Gitlitz's colleague who teaches Latin, Greek, and classical civilization courses as a full-time ad hoc lecturer at URI, volunteered to donate 60 percent of his liver.
"I'm still blinking at the wonder of it," says a grateful Gitlitz. "The operation's not trivial for the donor, even though the remaining 40 percent will, like a salamander's tail, regenerate itself. Still there's a protracted recovery period and the surgery leaves a scar the size of the old Jamestown Bridge." "When I learned that David was going on the transplant list, I realized that for the first time in my life I had the opportunity to save a life and thought that I should not pass it up," explains the 44-year-old Carpenter. "Also, I considered David a good friend and mentor and wanted to do all I could to help him. Initially, I thought that it was unlikely that I would be a match, and that, if I was, I would be able to consider the consequences then. By the time I was approved as a donor, the team at the Lahey Clinic had allayed most of my fears. The chance of a catastrophic complication was less than one half of one percent, though, of course, there was still some trepidation."
Six other people besides Carpenter offered to share their livers with Gitlitz—his brother John, two daughters Deborah and Abby, Abby's friend Richard Willey, and two good friends, David and Susan Offer who now live in Maine.
Matching livers requires compatible blood types, comparable body mass, and similar placement of ducts, veins, and arteries. Donors should be in good health, under 60 or so, and free of certain diseases and surgeries.
Five of the seven potential donors were eliminated or relegated to the liver-of-last resort list, leaving Carpenter and Willey. While neither was an ideal candidate because of body mass, Carpenter was the doctors' number one choice. Each man underwent a liver biopsy. Both were rejected as donors for questions of weight and body mass, Carpenter for his fat level.
Offended and motivated, both men went on diets. Within three months, Carpenter had lost about 25 pounds by stepping up his exercise regimen to include walking two miles every day and by avoiding white bread, sugar, etc.
Carpenter asked Lahey to re-biopsy his liver "a first for the hospital. The biopsy revealed a liver fat level below the necessary minimum. The surgery was a go, so on March 5 of this year, Dr. Elizabeth Pomfret removed 60 percent of Carpenter's liver during a six-and-a-half-hour surgery and handed it to Dr. James Pomposelli, who, after removing Gitlitz's diseased liver, replaced it with Carpenter's donation.
Most of Carpenter's liver will regenerate in the first three months, with the rest taking about a year. He expects to recover between 80 to 100 percent of his liver mass. He's taking three different kinds of medications, but expects to be free of them within the next few months. Right now, Carpenter tires easily, but improves daily as his liver regenerates.
Gitlitz says that he has lost 75 pounds since winter break, 40 of them since the eight or so hours of his surgery "I look like one of those day-after-liberation photos from a concentration camp," he said two weeks after the surgery. "I have a lot of extraneous bits running out of me or nailed to me. My skin is a cheery yellow color. I can work in intense bursts of up to 20 minutes or so. Closely observing the recovery process is going to be like watching paint dry for the next six months or more.
"The last tubes will eventually come out. The 44 industrial-sized staples holding me together will be removed. The obsessive compulsive self-monitoring will taper off (daily weight, blood pressure, fluids in " fluids out, grams of protein and carbohydrates per day, etc). Maybe I'll even finish the book I've been working on for the past couple of years."
Gitlitz takes a dozen or so medications and will have to take some anti-rejection medication the rest of his life. He should recover fully within six months to a year. "I hope to come in the short side of that," he says.
Gitlitz is still pinching himself. "The deep love and reciprocal commitments of family members and —for the fortunate few— of best friends, is one thing," he says. "But up until several months ago I wouldn't have thought of either Dan or Richard in that way, though I sure do now. The best I can do is ascribe it to altruism, their unselfish commitment to my welfare. I feel certain that they would be offended by any hint of expectation of external reward, be it recognition, esteem, or even thanks. I suspect, though because altruistic is not an adjective I would ever use to describe myself, that altruism derives satisfaction from itself. It moves from within, motivated only by some mysterious positive impulse deep within the wellsprings of a person's character. And that is something Richard Willey, the other volunteers, and especially Daniel Carpenter have in full measure. They are my heroes."
"I would encourage everyone to sign donor registration cards," Carpenter says while convalescing at the Wakefield home he shares with Jean, his wife of one year and their African gray parrot, Circe. "Also, if they ever have the opportunity to become a liver donor, they should consider it. I know that the experience has been one of the most fulfilling and meaningful of my life."
"Whether you give permission for your usuable organs to be harvested after your death, or decide to share an organ during your lifetime, as Dan did, you can do your part to share the gift of life," says Gitlitz.
The Rhode Island Division of Motor Vehicles, in conjunction with the New England Organ Donor Bank, allows you to register to be an organ donor when you renew or obtain a new license. The states of Connecticut, Maine, and Massachusetts also offer the ability to sign up for organ or tissue donation through their DMV license process. For more information, visit www.neob.org/For extended information about organ donation, visit the United Network for Organ Sharing at http://www.unos.org/ or Donate Life America at http://donatelife.net./ or call 804-782-4920.
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