2 triple-organ transplants in 2 days
A Chicago man and a Michigan woman get new hearts, kidneys and livers.
Two people were walking, slowly, down a hospital hallway.
One was a man, the other a woman. He was black, she was white.
As they walked — this was on Thursday — nurses and doctors cheered them on, like bystanders on a marathon route. “There’s my man!” “Ah, look at you! Looking good!”
“How many laps you doing now?”
The man’s name is Daru Smith. Hers is Sarah McPharlin. Before they came to University of Chicago Medicine, they had little in common.
McPharlin grew up in Grosse Pointe Woods, Mich., one of three daughters of a special education teacher and an international product planning manager at Chrysler. Smith grew up on Chicago’s South Side, the fifth of seven kids, raised by his mother, who managed a Harold’s Chicken Shack.
Smith drives semitrucks for a living. Before life brought McPharlin to the hospital, she worked as an occupational therapist and was in grad school.
Nothing in the backgrounds of these two suggested they would ever meet, and yet now they share something extraordinary.
Near the end of December, Smith and McPharlin, who are both 29, received new hearts, livers and kidneys in a rare procedure known as a triple-organ transplant.
He went first. A few hours after his surgery was over, hers began.
It was a feat of modern medical wizardry, one for the record books, yet one that depended on something ancient if not simpler: the human will to live.
Sarah McPharlin was 12 when she received her first heart transplant. Shortly after that, the virus that had attacked her original heart attacked her new one. She had a pacemaker installed. Other heart surgeries followed. Through it all, she grabbed at life.
She skied, bicycled, sailed and participated several times in the Olympic-style Transplant Games of America, always encouraged by a family so tight-knit that when she talks about herself she often says “we.”
“We could tell I wasn’t feeling as well as I had,” she said Thursday, sitting on her hospital bed. “Sixteen years out, it was probably time for a new heart.”
She soon learned that she needed a new liver too, and that transplanting a liver and heart would require a hardier kidney. Finding a hospital to do such complex surgery wasn’t easy, which is how she wound up at UChicago Medicine.
In early November, after her family rented out their Michigan house and found an apartment in Chicago, McPharlin settled into the hospital to wait for a donor.
Daru Smith’s arrival at the hospital wasn’t nearly as neat.
For the previous three years, Smith had driven a semi, crisscrossing the country for days at a time. It was a job he sought after his son’s mother got pregnant and he didn’t think he could support a child on the weekly $358 he earned as a cashier and cook at a Harold’s.
He knew he had diabetes and an inflammatory disease called sarcoidosis, but he was convinced he could manage both by eating right.
Out on the road in his semi, though, he began to feel chest pains, generally at night, and it made him nervous. Sometimes he’d text his mother with his location and truck number, telling her that if she didn’t hear from him by a specified time to call an ambulance.
On Nov. 8, he wound up in the hospital with pneumonia, his body swollen with fluid.
“He was crashing,” said Dr. Nir Uriel, the cardiologist who coordinates the care for Smith and McPharlin. “Almost dead.”
Not only was Smith’s heart failing, so were his liver and kidney. When he was told he might be a candidate for a triple-organ transplant, he’d never heard of the procedure.
Uriel had determined easily that McPharlin was suited for the complicated surgery — she’d sought it out, was calm and wellinformed — but not everyone is psychologically equipped for such radical physical change.
Think of it, Uriel said: “You have three organs inside your body that aren’t yours but are you now.”
After talking with Smith, Uriel was convinced he had what it takes.
“Daru said, ‘I have a 3-year-old kid,’ ” Uriel recalled. “He knew what makes his life meaningful.”
While waiting for their donors, Smith and McPharlin got acquainted in the physical therapy room. She found him quiet but friendly and admired how hard he worked. He found her humble and free-spirited, “just like smooth sailing.”
They walked the halls together, biding time, trying to stay strong.
“Sarah be knocking those laps out,” Smith said Thursday, noting how her determination egged him on.
Finally, on Dec. 18, a call came: A heart, kidney and liver were available for Smith. The name and circumstances of the donor’s death are closely guarded, so Smith didn’t know who had died to help him live, but he knew that for his son he had to.
“By me letting go of my fears early, I beat the depression I might have,” he said.
To himself, he often invoked his mantra: “Daru, you got this,” though on the day of surgery, spotting his family and friends crying outside his room, he shed a few tears too.
In the meantime, McPharlin didn’t mind that a donor hadn’t yet been found for her. In fact, she worried about having such tricky surgery so close to Christmas.
“I didn’t want Christmas to be someone’s memory of a death,” she said.
But even as Smith lay on the surgical table, another call came in: There was a donor for McPharlin.
“You’re kidding me,” Uriel remembers thinking.
And so the medical team did what it been preparing to do, though no one expected to do it twice in two days.
The heart surgeon replaced Smith’s heart, and then McPharlin’s, new hearts that had to be stable enough to make the rest possible. The liver surgeon replaced his liver, and later hers. The kidneys came last.
Smith’s surgery started on the Wednesday afternoon before Christmas and was over Thursday morning. McPharlin’s surgery started that Thursday evening and was done by Friday afternoon.
According to UChicago Medicine, they became the 16th and 17th people in the country to undergo this kind of triple-organ transplant, and the hospital became the first to do the procedure back to back.
“These are people that have a lot of life in them,” Uriel said. “They have dreams, hopes, things they want to experience, things they want to give.”
Smith and McPharlin know what a rare gift they’ve been given, the gift of another human’s organs, the gift of a talented medical team and the gift, they hope, of a long life.
On Thursday, as they neared the end of two laps of the fourth floor, their post-surgery record, someone called out, “Finish line!”
But they know the long walk is just beginning, that the first year after a transplant is the riskiest. For now, Smith can’t wait to get home to see his son. McPharlin is eager to get back to her family’s Chicago apartment to eat breakfast at the window with a view of the lake.
They don’t know when or where they’ll see each other after this, but whatever comes, they’ll always have the bond of the hard thing that brought them together, and of those slow, hopeful walks.
“These are people that have a lot of life in them. They have dreams, hopes, things they want to experience, things they want to give.”
— Dr. Nir Uriel, cardiologist