By: Ernest Gurulé
The first liver transplant in the United States took place not quite sixty years ago with Denver playing a significant role in the then pioneering procedure. And while no surgery is without some risk or complication, the fact that today there are more than 8,000 liver transplants done annually all across the country makes this pro- cedure not routine, but at least common place.
New Mexican Berlinda Rivera, a 61-year-old finance officer, is one of the 8,000 people who underwent the surgery in 2021. But what makes Rivera’s story more curious, more anomalous than, perhaps, so many of the others is that she has a close connection to a handful of family members who’ve either had the surgery, may one day have it or passed away from a failed liver.
“It’s hereditary,” said Rivera from an Aurora motel room where she and her husband have been staying as she recovers from the operation. The motel also keeps her close to her doctors who she sees during her recovery. She has another appointment this week.
Rivera got her new liver, which has become something of an unwanted but necessary family tradition, in November. “My sister got a liver transplant eight months ago.” A first cousin also received a new liver eight years ago. Luckily, another of Rivera’s sisters who lives in Alamosa, so far, is showing no signs of liver disease. But with the family’s track record, said Rivera, there’s naturally some concern.
Rivera’s first indication that something might be wrong came in a doctor’s visit last year. “They told me I had a fatty liver,” she recalled. The words were eerily identical to those her sister had heard the previous year. Fatty liver; cirrhosis. She would need a new liver.
Cirrhosis is the most common cause of liver failure and need for transplant. Cirrhosis, often caused by alcohol abuse, hepatitis B, chronic hepatitis C or an autoimmune hepatitis, replaces healthy liver tissue with scarred tissue. But Rivera’s condition was genetic, not lifestyle.
Rivera and her husband had suspected something might be wrong even before hearing her doctor’s words. In 2020 she was feeling fatigued. Her husband, Steve, said he also saw some something else, something more concerning. “It was the color in her eyes, her skin, it was changing. She was turning yellow, jaundiced,” he remembered. With no small sense of urgency, he told her, “You’d better get to the doctor.”
At Albuquerque’s University of New Mexico Health Center she was told she would need a new liver. Cirrhosis, a tell tale sign of failure, had set in. “They treated me for a few months,” before her doctors recommended she come to the University of Colorado Anschutz Medical Campus. The UNM doctors told them, “It’s the best in the region.”
CU facility performs an estimated one hundred liver transplants each year. The figure is a quantum leap from 1963 when the first such operation was attempted. On May 5, 1963, Dr. Thomas E. Starzi, a Denver VA transplant surgeon, successfully performed the operation. The patient died, but not because the procedure failed but rather because he contracted pneumonia. It would be another four years before Starzi repeated the procedure. This time the patient survived for more than a year.
A healthy liver is essential to good health. According to the Johns Hopkins website, “all the blood leaving the stom- ach and intestines passes through the liver.” There “it is processed and breaks down, balances and creates the nutrients and also metabolizes drugs into forms that are easier to use for the rest of the body or that are nontoxic.”
Rivera knew that without a new liver, quality of life would plunge or worse. “At first,” she said, “I was a little bit scared. But I prayed.” She said her faith was essential in the process. Her prayers always ended with a single phrase. “Your will be done.”
To get on a waiting list, Rivera had to follow a strict protocol which included getting a list of shots. After her regular visit last November, despite not knowing when the operation would take place, she was ready. But as she and her husband headed back to their home in Amalia, a tiny hamlet near the Colorado-New Mexico border, the call came. “We were just south of Pueblo,” said her husband. The voice on the other line told them to turn around, a donor had been found. They were back at the hospital in less than two hours.
The Riveras will never know their donor. Maintaining confidentiality is strict protocol. The only thing they can say with any certainty is what hospital officials have shared with them. It was “a young lady between 35 and 45.” A stranger from California. “Someone,” she said, “who gave us the gift of life.” In a bittersweet afterthought, she added, “I will never know her, but I will always be grateful.”
After arriving back in Denver and at the hospital, the anxiety that had been building on the quick turnaround peaked. “Oh, my gosh,” she thought. “I had been wanting an answer (about the liver) then here I was, right in surgery.” Her next thought, she said, was simple. “OK, Lord. Give me a hand.”
The surgical team began prepping Rivera for the opera- tion at 10:30 p.m. on November 16th. Eight hours later, the operation was complete, and recovery began. Today, nearly two months later, Rivera estimates her recovery is “probably between 70 and 80 percent.”
“The doctors have told me that they want me to begin walking. They also want me to eat more.” Her husband said she has lost around 25 pounds since the operation. She estimates her current weight at “around 110 pounds.”
Though the Riveras have insurance, it won’t cover everything,” said Rivera’s husband. “We’re going to have to put out a lot of money ourselves,” said the retired U.S. Forest Service heavy equipment operator. It’s a price, he said, they’ll gladly pay.
With the life-saving transplant surgery behind her, Rivera plans to follow her doctor’s advice and work toward full recovery. She said she’ll be allowed to resume her previous diet, with some exceptions, one of which will be ‘no grapefruit.’ Other than that, she’s free to plan her future, part of which is charting a path to retiring.
