The tale of an unexpected liver transplant. When I arrived at the Freeman hospital by ambulance from the Brompton Hospital in London, the thought of having a liver transplant had never crossed my mind. My problem was with my heart. I was born in 1965 with a single ventricle - essentially half a heart. I had undergone open heart surgery to rebuild my heart, so the my single ventricle could pump blood around my body, while my lungs received blood directly from my venous system, via the right atria. It was a remarkable operation, the rst of its kind, and it allowed me to grow up and have a near normal life. As I got to the other side of 45, things started to go wrong. Arrhythmias, uid overload, leg ulcers, burst varicose veins and a belly so full of uid that made me look like a pregnant man. They were all symptoms of high venous pressure and right heart failure. Eventually the doctors at the Brompton Hospital told me I needed a new heart, and that the only place in the UK with any experience of operating on people with single ventricles was in Newcastle. Typically, children in the 1960s and 70s with complex congenital heart defects like the one I had weren't expected to survive into adulthood. So, when the congenital heart disease doctors at the Freeman saw me, their conclusion was “you're not like any of the single ventricle patients we've seen before!” Basically, they hadn't come across anyone who had survived as long as I had. The doctors told me that the patients like me who hadn't survived after heart transplant, died because their livers weren't strong enough to survive the operation. They thought that for me to stand a chance I would need a combined heart & liver transplant. So, after a brief time back at home, I returned to the Freeman hospital a few weeks later for my Liver Transplant Assessment. It was strange having a different series of tests compared to the usual cardiac ones that I had got used to over the course of my life. While I was on the ward, one of the nurses realised that I was leaking uid from my bellybutton, due to the terrible ascites that I had developed. With a degree of urgency that surprised me, a doctor was summoned to drain the uid from my abdomen. Within a few hours, 14 litres of uid were drained from my belly. It was such a relief to be nearly 14kg lighter and no longer looking like I was 8 months pregnant. I returned home again to be there for my daughter's 18th birthday. I wondered that if I took things easy and stuck to the uid restriction diet I was on, all that uid might not come back, and then I could delay the Transplant a few years. However, within a couple of weeks, it was clear that whatever I did, I could not stop the uid returning. Within a month the ascites was worse than ever. I came back to the Freeman with my wife for a meeting with Professor Manas. He didn't pull any punches and told us having a heart and liver transplant was a massive operation to undertake and that the chances of survival were 50:50 at best. He told us that the liver and LIVErNEWS No. 75
~ 13 ~ Summer 2021
