The first time I performed an organ transplant in the nick of time

With only one week to live, it was a race to find a suitable donor. So the patient’s brother stepped forward.
Marwan Kazimi
Dr. Marwan Kazimi

Photograph by Ben Rollins

Dr. Marwan Kazimi
Surgery, Piedmont Transplant Institute

She was a college
student who developed what’s called fulminant liver failure, which happens to probably 2,000 people a year in the country. Without a liver transplant, she would have died within a week.

The first time I met her, she was in an intensive care unit. The disease had affected her brain function, and she wasn’t completely aware of what was going on.

I knew we were in a race against the clock because if you don’t get a suitable liver donor—even though patients like her are bumped to the top of the regional wait list—there comes a point when they get too sick to transplant, or they succumb to infection. We were doing everything we could, but it was clear after three days that we weren’t getting any offers for her. That’s when her brother stepped forward and said he wanted to donate a portion of his liver. He was so young, just a couple of years older than her.

The liver is unique in that it can regenerate, but transplanting from a living donor is still rare. Among other things, you’re taking somebody who’s totally healthy and exposing them to a complex surgery with its own set of risks and complications. We tested him for a blood type match. We made sure he didn’t have the same liver disorder trait that had caused his sister’s condition, which he did not. And then we did specific imaging of the liver to check that the anatomy was compatible. All of that got done within 24 hours, which is a very quick turnaround.

We started the donor’s surgery on a Sunday morning, and the graft was implanted in the patient that evening. Usually when the transplant is successful, the patient gets better within 24 hours. And she did. Her brother also did great. He went home in five days, but he kept coming back to see his sister, and I think she got discharged after 12 days. Now they both have graduated from college.

Of course, it was extremely gratifying to save this girl’s life. But even more special was to see the love that this brother had for his sister. The outcome was really a testament to the family’s strength. —As told to Josh Green

This article originally appeared in our July 2017 issue.

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