Your Money Or Your Life: A Stranger's Gift

Transplant Waiting Lists Too Long For Sick Man

George Aukerman underwent surgery that he doesn't need and that might have killed him.

He gave half of his perfectly healthy liver to Kenny Franciscus, a man he barely knows but who desperately needs the liver for survival. Correspondent Erin Moriarity reports.

A few months earlier, Franciscus, 42, had gone to see a doctor, complaining of a loss of appetite and weight. The diagnosis shattered what seemed like a perfect life. He discovered that he has primary sclerosing cholangitis, a disease that is destroying his liver.

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At the time, Franciscus and his wife, Vicki, were in northern Thailand, working as missionaries and raising their six children. Told he would die unless he got a transplant, Franciscus and his family returned home to Pittsburgh.

The sad and awful truth about the system in this country is that if Franciscus wanted a transplant, he had to wait for someone else to die and donate a liver. What's more, he had to get in a very long line.

In Franciscus' case, that wait could be as long as two years. "I don't think Kenny had two years to wait," says Dr. John Fung, head of the transplant center at the University of Pittsburgh Medical Center. "If he had to wait two years, I think he would have died."

So instead of depending on the national system and waiting for a liver, Franciscus decided to go looking for one on the Internet.

Dr. Fung says it's not easy to find a living donor. Donating part of a liver can lead to serious complications for the donor, including death.

Both Vicki and their son Zach volunteered, but when the test came back, neither were suitable donors.

"Our pastor found out about this," Franciscus says, "and said, 'This is ridiculous; you've got a church of over 500 people.' And he said, 'I think we should widen the pool.'"

The Franciscius family didn't have to look past the balcony of their own church.

Aukerman, 42 and a youth counselor, was working the audio board there when, from the pulpit, came the call for volunteers.

"The instant they made the announcement," Aukerman says, "I just felt it in my heart that it was something that I wanted to do. And I turned and looked at my wife. And I said, 'I'm gonna do that.'"

Taking risks is nothing new for Aukerman, a former Naval officer and a formidable athlete who teaches mountain climbing. Aukerman, who has a wife, was playing Russian roulette.

"Whether or not he really appreciates the risk or not, I can't tell you," Dr. Fung says. "I would hope he does."

Aukerman says it didn't matter. "I mean, if the guy needed a liver and I could deliver. I look at it this way. If God's gonna ask me to do that, he'll take care of the details, you know?"

Without Aukerman, Franciscus would be in the same boat as some 80,000 Americans who need transplants to stay alive.

Dr Fung says there just aren't enough donors and the national program to distribute organs fairly and quickly doesn't work.

"In this country there are pockets of the geography where the waiting times are very short," he explains. "And there are parts where the waiting times are very long."

In other words where you live can determine if you live. While the distribution program is national, each region of the country has its own waiting list. The result is that patients who happen to live across the river on the New York side have a two to three times longer wait than patients who live here on the New Jersey side.

"Nobody really takes into account a national perspective," Fung says. "The organizations and the transplant community are satisfied with the status quo, which is, each deals with his own problem locally."

Because individual regions aren't required to share, organs don't always get to the people who need them and, in some cases, are actually discarded.

"When you know 20 or 30 percent of the patients on the waiting list are dying every year," Fung says, "as far as I'm concerned, that's a crisis."

The first challenge for the transplant team is also one of the toughest to carefully divide Aukerman's liver. " We ended up taking about 50 to 60 per cent of George's liver," the doctor says.

Then follows a critical moment for Aukerman - will the remaining half of his liver work? A perfectly healthy man six hours ago before, he was in danger of complete liver failure.

At the same time Dr. Fung was working on Aukerman, another team was at work on Franciscus. Doctors needed to customize the donated organ to fit him.

"We actually had to put on an extra piece of vein," Fung says, "to allow the blood flow out of, Kenny's liver, I mean out of George's half liver.

The 15-hour surgery went smoothly. Fifteen days later, Franciscus' new liver was working well with anti-rejection drugs, and Aukerman was getting ready to go back to work.

"It's a miracle," Franciscus says. "My skin color is good and I feel good. It's pretty amazing."

The medical marvel that makes liver transplants possible is that a liver cut in half will actually grow back to nearly full size.

"My liver was larger than normal, believe it not," Aukerman says. "So I've ended up with 80 per cent of what I originally had. But it's basically the size of a normal liver."

Franciscus knows he's lucky going around a transplant system that often doesn't work, with a failure rate measured in lost lives.

"I'm so grateful, to George, to my church, to God," he says. "And I believe it was for a reason. I can't live with the guilt, or feeling badly that I got a liver, and other people didn't. ut I know I have one now, and I want to make the most of it. I want to make the most of what I have left."
  • Emily Cartwright

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