The miracle of solid organ transplantation
Thanks to organ donors, the Olhausen’s are elated to continue gathering for family events, from weddings to fishing, with Dad.
According to DonateLife.net, 22 people die waiting for an organ transplant each day, and one person is added to the organ transplant waiting list every 10 minutes. With these statistics, you could say it is a miracle to receive a solid organ transplant. Organ donation and transplantation holds a special place in my heart, as this miracle allowed me to grow up with my best friend: my dad.
The long road
Shortly after turning 25, during a routine check-up for his ulcerative colitis, tests confirmed my dad had a rare inflammatory disease called primary sclerosing cholangitis (PSC). This disease causes scarring of the bile ducts and eventual liver failure. The physicians were not sure if it would be within the next month, year, or few years, but he would need a liver transplant. Ten years after receiving the diagnosis, my aunt graciously donated 75% of her liver to my dad as they underwent a living donor transplant. Dad was never 100% after the transplant, though. His bile duct continued to collapse, so an external stent was placed to keep it open. It needed changing about every 3 months. We would know when it was time to replace it, as Dad would get very sick.
Immunosuppression is required to prevent the body from rejecting the new organ after a liver transplant, which comes with the increased risk of a group of cancers classified as post-transplant lymphoproliferative disorder (PTLD). We knew deep down this was a risk, but it didn’t feel real to us until 7 years after the transplant, when Dad developed stage 3 non-Hodgkin’s lymphoma. After enduring months of chemotherapy, experiencing about every adverse effect possible, he was cancer-free!
Dad was doing well when, on a hunting trip 3 years later, he felt extremely fatigued, nauseous, and in pain. After numerous tests, we learned his PSC had resurfaced and destroyed his transplanted liver. With the history of PTLD, his hepatologists were not certain another transplant was an option. The final decision would be made by his oncologist, who was on vacation at the time, but the hepatologists were not optimistic. We all prepared for the worst.
However, after a long and agonizing week, the oncologist approved a second transplant for Dad, this time from a deceased donor. During the transplant, the surgeon found significant adhesions to his old liver, to which fixing had caused a lot of bleeding. He lost over 2 liters of blood and required 8 units of plasma and 21 units of blood—roughly 2.5 normal-sized adults worth. Eight hours later, Dad was out of surgery and in the ICU for recovery. Following this transplant, he felt better than he could ever remember and did not need any stents. We were elated and thought we were finally in the clear.
Three years flew by and I had just started my first year in pharmacy school when a medication-induced liver injury caused by an antibiotic resulted in irreversible damage to Dad’s new liver. He was on the transplant waiting list, and it was time for us to fight the same battle yet again. Even though Dad had the highest possible MELD score (a measure of liver disease severity), the waiting continued. The longer the wait, the more his kidneys deteriorated, eventually leading to end-stage renal failure. Now we were praying for both a liver and kidney, instead of only a liver. After 6 exhausting months, we finally received the call that they had organs for him and his transplant would be performed that night. Dad actually flatlined during the transplant, truly scaring us all.
Today, I can say with relief that he is still with us, healthier than he has ever been.
Inspired by pharmacists
Dad was diagnosed with PSC before I was born, and I was 23 when he had his last transplant. I have grown up in the medical world my whole life and always knew I wanted to go into the health care field. In high school, Dad told me about the important interventions pharmacists made in his care while he was hospitalized and how they fully educated him on all his medications in the outpatient setting. I decided I wanted to make this kind of impact in the lives of others and chose to go to pharmacy school.
After learning about Dad’s antibiotic-induced liver injury and seeing how closely his medications were monitored immediately post-transplant, I knew I had chosen the right career. My passion for organ donation and transplant, of course, stems from my personal experiences. But it has only grown as I learn more and see how important pharmacists are to the care team. Pharmacists have the ability to optimize therapy for patients and manage life-sustaining medications alongside the other medications they take for additional disease states. They can minimize adverse medication events, like medication-induced liver injuries. Also, there is the opportunity to save others by registering to be organ donors, like those who saved my father.
Love having my best friend around
When I reflect on all that my family has been through, I am met with feelings of appreciation and gratitude. Had it not been for those who made the selfless decision to be an organ donor, Dad would have missed out on our graduations, my sister’s wedding, my white coat ceremony, and meeting his grandchildren. This journey has only strengthened our Christian faith and our relationship as a family. It would be dishonest to say I never feel anxious for the future, but I know I am fortunate to be able to still have my dad in my life and present during the big moments. I thank God for this gift every day.
Please, consider making the choice to donate life by registering to be an organ donor.
Morgan Olhausen is a final-year PharmD candidate at the University of Minnesota College of Pharmacy–Twin Cities and the 2019–20 APhA–ASP Region 5 Regional Member-at-large.