Thousands travel a path like Slater's

By Carol M. Ostrom
Seattle Times staff reporter

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Related stories After a long wait, Jack gets a liver transplant The wait, through his eyes

Last night, Jack Slater was joining more than 63,000 people in the U.S. who have received a liver, or part of one, that once belonged to someone else — as Slater put it in one of his columns for this newspaper, a "pre-owned" liver.

It's a complicated operation, more so than the transplantation of some other organs, such as kidneys. Typically, surgery lasts between six and 12 hours, in part because the liver has so many blood vessels that must be reattached. Slater was still in surgery at press time.

The liver has a certain cachet among medical people because it can regenerate. But some livers, like Slater's, have been too damaged to do that, and scar tissue forms, which keeps it from doing its job. Livers can be permanently damaged by disease, alcohol or other poisonous substances.

Slater has hepatitis C, a blood-borne infection that is now the leading reason for liver transplantation. Like most people who have hepatitis C, Slater had no symptoms when a routine physical led to his diagnosis in 1997, the same year he was hired to teach history at Seattle's Franklin High School.

But hepatitis C is a progressive illness, and Slater became ill. He had to take medical leave from his high-school teaching job in early 2002.

Over time, he began to experience many of the symptoms that go with end-stage liver disease, including muscle wasting, nausea, weight loss, fluid retention, abdominal swelling and hepatic encephalopathy, episodes of impaired mental ability that can range from disorientation and confusion to coma.

Slater dodged some other bullets, ones that can keep patients from getting transplants, such as liver cancer.

Liver-transplant facts Last year, 5,671 people in the United States received a transplanted liver, including 111 in Washington state. Most transplanted livers come from deceased donors who had agreed before death to donate their organs, or whose families made the gift. As of Friday, 17,480 people nationwide — 140 in Washington — were waiting for a liver transplant. Source: Organ Procurement and Transplantation Network

He's been on the transplant list at the University of Washington for nearly two years. In Washington state, about half of those on the list have been waiting a year or less, while about half have been on the list from one to five years.

Almost certainly, Slater's new liver will contract hepatitis C from him.

Most studies indicate that short-term survival rates for hepatitis C patients who have had transplants are similar to those of patients who underwent transplantation for other reasons. But a large 2002 study suggested that five-year transplant outcomes may be poorer for hepatitis C patients.

A more recent, smaller study concluded that 10-year survival rates were about the same for transplant patients with hepatitis C — 67 percent — as for patients who had transplants for other reasons — 59 percent.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com

Copyright © 2004 The Seattle Times Company

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