Despite the odds, liver transplant saves his life

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Nonalcoholic steatohepatitis, the most serious form of nonalcoholic fatty liver disease, led James Campbell to a liver transplant.

He was lucky.

The disease, which had progressed to cirrhosis, almost killed him.

"He was the sickest patient I've ever done," said liver transplant specialist Ngoc Thai, director of the Allegheny General Hospital Center for Abdominal Transplantation. "In another 24 hours he would have been dead."

The transplant, made more difficult by the fact he weighed more than 300 pounds, was Nov. 17, 2008. Mr. Campbell, now 61, was in and out of various health facilities recovering until July 15, 2010.

The comeback continues for the former McCandless man, whose health forced him to retire as port director of the U.S. Customs Service at Pittsburgh International Airport. Having moved recently to the Austin, Texas, suburb of Pflugerville to be near his grandchildren, Mr. Campbell reports that although he still spends most of his time in a wheelchair, he can now walk 600 feet with a walker.

"It took a long time for him to recover," said Dr. Thai, who calls his patient a "tough guy."

"He did very well. We would not do anybody sicker than him. I remember taking him from ICU to the operating room as his blood pressure was dropping. His liver was dying as I was taking him to the operating room."

Mr. Campbell was diagnosed with his liver disease about a year and a half before his transplant. That's when esophageal varices, blood vessels swollen by pressure caused by scarring in the liver, burst. "I almost bled to death in an emergency room at [UPMC] Passavant Hospital," he said.

Later, he said he had a second "bleedout"; then he developed ascites, an accumulation of fluid in the abdomen. He had a shunt put in to relieve the fluid and pressure.

On top of everything, he had diabetes and hepatorenal syndrome, a condition in which the kidneys fail because of inadequate liver function that left him on dialysis. Usually, patients with kidney failure have a much worse outcome after liver transplant, Dr. Thai said.

Mr. Campbell went to the Allegheny General emergency room about six weeks before his transplant because a doctor friend said he needed to. "I felt tired, but my family said I looked a little yellow," he said. He didn't leave for a long time.

"I went right from the emergency room into the hospital and to the care of Dr. Thai."

Placed in intensive care, Mr. Campbell had a breathing tube inserted and began waiting for a donor liver in a state of "part terror and part anticipation. ...

"It was difficult because I was so sick and I was in intensive care, and I was rapidly losing motion in my arms and legs from the inactivity."

About 50 percent of the time, Dr. Thai said, kidney function comes back after liver transplant, but Mr. Campbell's hasn't and he remains on dialysis. He is on the list for a kidney transplant at AGH but said he is re-establishing medical connections in Texas.

Yet he remains upbeat. "It's a steady road of improvement," he said.

"I'm very grateful for the people at Allegheny General who were able to keep me alive. I'm very grateful to the insurance company -- it's one of the big ones -- which stood by me. I'm very grateful for all the people who were praying for me to stay alive, and I'm grateful for the people in West Virginia who lost their father and I have his liver."

Pohla Smith: psmith@post-gazette.com or 412-263-1228.

Nonalcoholic steatohepatitis, the most serious form of nonalcoholic fatty liver disease, led James Campbell to a liver transplant.

He was lucky.

The disease, which had progressed to cirrhosis, almost killed him.

"He was the sickest patient I've ever done," said liver transplant specialist Ngoc Thai, director of the Allegheny General Hospital Center for Abdominal Transplantation. "In another 24 hours he would have been dead."

The transplant, made more difficult by the fact he weighed more than 300 pounds, was Nov. 17, 2008. Mr. Campbell, now 61, was in and out of various health facilities recovering until July 15, 2010.

The comeback continues for the former McCandless man, whose health forced him to retire as port director of the U.S. Customs Service at Pittsburgh International Airport. Having moved recently to the Austin, Texas, suburb of Pflugerville to be near his grandchildren, Mr. Campbell reports that although he still spends most of his time in a wheelchair, he can now walk 600 feet with a walker.

"It took a long time for him to recover," said Dr. Thai, who calls his patient a "tough guy."

"He did very well. We would not do anybody sicker than him. I remember taking him from ICU to the operating room as his blood pressure was dropping. His liver was dying as I was taking him to the operating room."

Mr. Campbell was diagnosed with his liver disease about a year and a half before his transplant. That's when esophageal varices, blood vessels swollen by pressure caused by scarring in the liver, burst. "I almost bled to death in an emergency room at [UPMC] Passavant Hospital," he said.

Later, he said he had a second "bleedout"; then he developed ascites, an accumulation of fluid in the abdomen. He had a shunt put in to relieve the fluid and pressure.

On top of everything, he had diabetes and hepatorenal syndrome, a condition in which the kidneys fail because of inadequate liver function that left him on dialysis. Usually, patients with kidney failure have a much worse outcome after liver transplant, Dr. Thai said.

Mr. Campbell went to the Allegheny General emergency room about six weeks before his transplant because a doctor friend said he needed to. "I felt tired, but my family said I looked a little yellow," he said. He didn't leave for a long time.

"I went right from the emergency room into the hospital and to the care of Dr. Thai."

Placed in intensive care, Mr. Campbell had a breathing tube inserted and began waiting for a donor liver in a state of "part terror and part anticipation. ...

"It was difficult because I was so sick and I was in intensive care, and I was rapidly losing motion in my arms and legs from the inactivity."

About 50 percent of the time, Dr. Thai said, kidney function comes back after liver transplant, but Mr. Campbell's hasn't and he remains on dialysis. He is on the list for a kidney transplant at AGH but said he is re-establishing medical connections in Texas.

Yet he remains upbeat. "It's a steady road of improvement," he said.

"I'm very grateful for the people at Allegheny General who were able to keep me alive. I'm very grateful to the insurance company -- it's one of the big ones -- which stood by me. I'm very grateful for all the people who were praying for me to stay alive, and I'm grateful for the people in West Virginia who lost their father and I have his liver."


Pohla Smith: psmith@post-gazette.com or 412-263-1228.


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