Biliary Atresia

Jeff and John smiling together

How My Friend Saved My Life

At 28 years old, Jeffrey Doerr was a pretty normal guy with a happy life. He had a good job, a loving family and a girlfriend who would eventually become his wife. Then one day at work he got the call from his doctor that changed everything.

“Jeff, you need a liver transplant.”

Jeff was born with biliary atresia, a rare disease of the bile ducts that damages the liver. The liver produces bile, which helps digest fat and carries waste to the intestines. When a person has biliary atresia, the bile is blocked from going to the gallbladder and becomes trapped inside the liver. When that happens, the liver gets damaged and scarred, which eventually leads to liver failure.

Jeff always knew he had a “bad” liver, but it gave him relatively few problems or complications. He felt a little sick one day and underwent routine blood tests. It was after a few of the blood tests and doctor visits that he received the call.

Pursuing a Live Liver Donation

Jeff and John in a canoeWhen Jeff found out he would need a liver transplant, he came to Penn Medicine to learn his options and how the transplant process worked. His hepatologist, K. Rajender Reddy, MD, explained that he could either wait for a deceased liver to become available or find a living donor liver.

“Initially, I was very skeptical about live liver,” Jeff explains. “Dr. Reddy said that there are a lot of good points to it. The main being that you know essentially exactly where your liver is coming from. You know the kind of person it's coming from and you know the quality beforehand. Also, with a live liver donation, you have a surgery date. You know when it's going to happen, and it's helpful to plan when you're going through such a stressful time.

Jeff also learned that with living donation, the donor is typically healthier. The disease hasn’t progressed while waiting for a deceased donation and, therefore, the recovery can be easier for the recipient too.

“Dr. Reddy walked me through the process,” Jeff continues. “I would be responsible for finding my own donor, which was interesting because I'm a recruiter by trade. So I could utilize those skills I’ve been using [chuckles] to place people in career positions to find a liver donor.”

When Jeff explained the living donor liver transplant process to his family, his brother, Mark, volunteered. Mark was five years younger than Jeff and had the same blood type. He was also in really good physical shape; he had rowed crew in high school and stayed active college. It seemed like the perfect match.

The two began the evaluation process including a very thorough medical and psychological evaluation to make sure Mark would be a suitable living donor candidate.

“Halfway through the testing process, we learned that even though he’s taller than me and bigger than me, Mark’s liver wasn’t big enough to sustain both of us through a living donation,” Jeff says. “To say I was disappointed would be an understatement.”

Living Liver Donation From a Friend

Jeff and Mark were both upset when they learned that Mark wouldn’t be able to donate. One of Mark’s best friends, John, came over to try to try to get him out of the house and cheer him up.

When John got there, he overheard Jeff and his mom talking about other options for liver donors. The topic of blood types spiked his interest.

“Well, we’re the same blood type,” John jumped in.

“You wanna donate your liver to me?” Jeff asked, without any preamble.

“Sure,” John answered, “What do I have to do?”

Liver Transplant Testing

Jeff and John in a canoeJohn had grown up with the Doerr family. He met Mark when he was seven or eight years old and was in the Eagle Scouts with both brothers. He went on camping, skiing and hiking trips with them.

After careful consideration, and much discussion with his own family and friends, John began working with the Penn Transplant living donor team to determine if he was a good match. Even throughout the evaluation process, John’s team encouraged him to understand the surgery and know the risks involved.

“My clinical team laid everything out on the table for me,” John says. “We discussed that, as with any serious procedure,  there is a very small risk of something happening. We were all on the same page.”

They told him at any point he could turn back. John, however, had made up his mind the day he said “yes.”

Jeff wanted to make sure that there wouldn’t be any extra burdens on John if he donated.

“The team at Penn assured me that no cost would be passed on to my donor, which was our concern first and foremost. Whatever cost came up for us, we figured by any means necessary we'd take care of it.  My insurance was helpful; I didn’t have to pay anything out of pocket for the transplant. I hope that John has never seen a bill and not told me about it. But as far as I know, he has not borne any cost whatsoever for this procedure,” says Jeff

A New Liver, a Stronger Bond

A few months later, John donated a portion of his liver to Jeff, and the transplant was a success.

After a few weeks of recovery and taking it easy, John was able to return to his normal, active lifestyle.

“I didn’t have any physical therapy or rehab to do, honestly,” John says. “My recovery phase was easy and went quickly.”

Since Jeff’s health had been deteriorating for several months before the transplant, his road to recovery was a little bit slower. It took him about six months before he could go back to work, but after a year he was hiking the Appalachian Trail.

“It was definitely a worthwhile experience. Jeff is still here and that's what really matters,” says John. And the scar, he says, is a proud reminder that he did something worthwhile.

Jeff adds that their friendship-turned brotherhood has been a special experience: “We have a unique bond. A piece of him is sustaining me while we both continue to prosper in life.”

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