After decades spent with hepatitis C, donated liver gives man his life back

The way J. Michael Trevino sees it, his life was saved twice.

Trevino, 64, a Houston lawyer and oil-and-gas consultant, contracted hepatitis C either at his Army induction or during his long-ago service in Vietnam, though the virus, which attacks the liver, didn’t even have a name then.

After having the virus in his body for decades, in September 2012 Trevino bowed to the urging of Dr. Michael Fallon, a gastroenterologist at Memorial Hermann Hospital and director of that division at UTHealth, that he undergo a drug regimen to eradicate the virus. After 48 miserable weeks — newer treatments are much more gentle — the virus was gone. “I felt myself to be very fortunate,” Trevino said.

That was, he believes, the first time somebody saved his life. The second time was a little more complicated.

Early in 2014, doctors detected a tiny, cancerous tumor on the surface of Trevino’s liver, a common result of having had hepatitis C for many years. Using a minimally invasive procedure called tumor ablation, doctors at Memorial Hermann killed the tumor.

Given the likelihood of more tumors appearing, the next action was clear. In April, Trevino went on the liver-transplant list.

New drugs that can cure hepatitis C carry the real promise of drastically reducing the number of people with the disease, reducing transmission as well. But for those who have been infected in the past, there’s a catch: The liver may be so damaged that the cured patient still has a higher risk of liver cancer.

According to Stacey Harris of the American Liver Foundation, patients who have had hepatitis C are at increased risk of cancerous tumors. The liver foundation, she said, doesn’t keep statistics on how many get cancer postcure, but patients should be aware of the possibility.

According to Dr. J. Steve Bynon, chief of abdominal transplantation at Memorial Hermann-TMC and UTHealth, Texas is a tough place to be if you’re hoping for a liver, offering one of the longest wait times in the country.

Unlike a kidney, which can come from a living donor, a whole liver can be taken only from someone who has just died.

“You’re asking someone to consider helping someone else at the worst time of their life,” he said. He encourages everyone who would be willing to donate to have a donor card or at least make preferences known to relatives.

The liver also must be a good match for the recipient.

For Trevino, months passed. On Nov. 20, he came back from a business trip to Washington, D.C. The next day, his daughter Margot’s boyfriend, Chuck Rosson, invited Trevino and his wife, Ileana, to lunch.

Rosson asked for Margot’s hand in marriage. “I took him straight to the jeweler,” the proud dad says.

That night, the Trevinos were getting ready for bed when Ileana reflected on the lunch. “What a redletter day,” she said.

Just then, her cellphone rang.

The voice on the other end asked for Joseph — Michael’s first name, which he doesn’t use. Ileana, who is CEO of the Memorial Hermann Foundation, nearly hung up.

“We think we have a vi- able liver,” the voice said.

“Are you kidding me?” Ileana said, gesturing toward her abdomen so that Michael would understand. Be ready to be at the hospital in two hours, the voice said.

Things can go wrong with donor livers. They can be in poor condition. The Trevinos called their three children and told them not to converge on the hospital yet. The kids ignored the advice.

Aliver can stay viable for only 10 to 12 hours. Time is everything.

Early in the morning, after some emotional goodbyes, Trevino was wheeled into the operating room.

The surgery, so momentous for this one family, was deliberately not so for the surgical team.

“It was uneventful and designed to be that way,” Bynon said. “That’s how you gain the most efficiency, if there’s no variation from the script.” (Bynon said the goal is to establish Memorial Hermann’s transplant team as “the best on Fannin Street” — because if you’re the best there, you’re one of the best in the world.)

At 3 p.m., a nurse called Ileana. The surgery went well. And sure enough, new tumors were growing in her husband’s old liver.

But more surprises were in the offing. The following Thursday, Thanksgiving, the Trevinos had dinner at the hospital, where Michael was still a patient.

With the help of the Trevinos’ other children, Mari and Miguel, Chuck Rosson maneuvered Margot into a lovely area of old Hermann Hospital and popped the question. She said yes.

Now Michael, steadily recuperating, looks forward to walking her down the aisle on Oct. 10.

He’s had other unexpected outcomes, too. He suddenly thinks much more clearly. (Toxins the old liver wasn’t cleaning out had been flooding his brain, Bynon said.) Small injuries heal more quickly. The whites of his eyes are startlingly white, and Ileana says his coloring is the best in years.

Michael cannot give enough thanks to the donor, whom he knows only as a woman younger than he. Nor can he praise his doctors enough.

“These guys are just amazing,” he said. “I don’t have the words to express my gratitude to both the donor and the doctors.”

kyrie.oconnor@chron.com