Expanded transplant services bring care closer to home
“It’s very emotional,” Mike Lewis said, his voice cracking. “Someone else had to die for me to have this opportunity.”
He’s talking about his life.
The 66-year-old retired Shelton police officer was diagnosed with cirrhosis of the liver 10 years ago, because of fatty liver disease.
“Cirrhosis is caused by many things,” said Dr. Elizabeth Richardson, a transplant hepatologist and gastroenterologist for Hartford HealthCare. “Fatty liver, alcohol, viruses, autoimmune disorders; there are many causes. Sometimes it’s a mild course, and sometimes there are multiple complications.”
For nearly a decade, doctors monitored Lewis’ disease with endoscopies every three months. Two years ago, his gastroenterologist thought it was progressing enough to start the process of getting him on the transplant list, so she set him up with Richardson.
In order to qualify for the next available liver, many factors must be in place, not least of which being a patient’s Model for End-Stage Liver Disease (MELD) score. According to Richardson, MELD scores range from 6 to 40, and the need for a liver transplant evaluation usually stands at 15 and above. However, she said most area patients receiving a transplant have MELD scores of 30 or above.
“Waitlist for transplant is a misnomer because time has nothing to do with it. It’s based on
medical acuity,” she said. “The higher the score, the sicker the patient. It’s all in the blood work. The score is based on an equation that has coefficients for variables determined by blood work and sex.”
That’s not all. To get a liver, there must be a blood type match, and the receiving patient must be in good enough health to undergo the surgery and have the body accept the organ.
When Lewis first met Richardson, he was simply meant to have annual meetings to check his MELD scores. But fate intervened.
“My gallbladder infected some fluids in my abdomen, and there were several procedures, but the infection kept coming back,” Lewis said. “They couldn’t take the gallbladder out with the cirrhosis.”
Suddenly, Lewis found himself bumped up on the list. His acute infection elevated his need, and a week and a half later, he got a call at 2:30 in the morning to drive up to Hartford Hospital. The seven-hour surgery was a success, and Lewis was discharged 10 days later.
While patients like Lewis have to travel to Hartford to get the top transplant surgery they need, the new St. Vincent’s Medical Center transplant clinic will cut his effort and travel by 90 percent, easing his recovery and making his life more comfortable.
“If you have to drive an hour and a half versus 10 minutes it’s a lot, and these people are sick,” Richardson said. “This is a proven algorithm. Hospital staff can travel to see people out in the community, outside of the flagship hospital, and that gives a broader reach for the people who need it. We’re committed to making sure everybody gets the care they need in a way that works for them.”
And it’s not just the aftercare that is made easier.
“Hartford Hospital’s liver transplant services are broadening to the Bridgeport and Fairfield regions to expand tertiary care in the community, and to extend our availability to patients that will benefit from reduced travel,” Richardson said.
“This means having patients be identified by their local doctors, and if they could need a liver transplant in the future, I evaluate them and figure out what’s been going on,” she continued. “Once that happens, it’s multidisciplinary: cardiac, cancer screenings, psychosocial — all the facets of transplant are included, and a lot of it can be done locally.”
Lewis continues to recover at home. Now that his staples have been removed, all his checkups can be done nearby. He had a nurse visiting to check his vitals and progress during the first few weeks, and then physical therapy started, again in his home. He plans on using Hartford HealthCare services through St. Vincent’s for the long haul.
“Recovery is going well; they say I’m advancing faster than most,” he said. “Dr. Richardson has a human touch. She’s genuine. Twice she came in to see me when she wasn’t working, just to check on me socially.
I got a winner there, a keeper, so I’ll be seeing her from now on.”
This is just one example of Hartford HealthCare St. Vincent’s Medical Center bringing more specialists and providers to the community. Tune in to Hartford HealthCare St. Vincent’s Medical Center’s Facebook Live discussion, where you can ask your questions, on Thursday, April 25, at noon. For more information, start here: hartfordhealthcare. org/transplant.