The Challenge: Nonalcoholic Steatohepatitis (NASH) and Liver Cancer
Michael Rosenstein was sick. He just didn’t know it.
During an appointment with his doctor for knee replacement surgery, his bloodwork revealed a hidden illness. He was eventually diagnosed with nonalcoholic steatohepatitis (NASH). This disease is like alcoholic liver disease, but it occurs in patients who drink little or no alcohol. It occurs when a buildup of fat causes inflammation within the liver, which for some people can cause serious damage and lead to liver failure.
Patients diagnosed with NASH often do not experience the typical symptoms of liver disease. That’s why it’s often thought of as a silent disease, but it can still be very damaging to your life.
“Physically I was always fine,” Michael said, “But the shock of finding out so suddenly had me feeling down. I was very concerned.”
What he really struggled with was the feeling that he had no way forward, no way to get healthy. While he was not sick enough yet to qualify for transplant, his doctor told him that his liver disease would get worse until he would need a transplant to survive.
Michael was stuck, waiting.
The Path to Living Donation at UPMC
Because he knew he would one day need a transplant, Michael saw a specialist at the UPMC Center for Liver Diseases. He wanted an established relationship at a hospital with a major transplant center for when he finally did qualify for transplant.
Michael continued to see his local doctor regularly to keep track of his status. He kept in regular touch with his doctors at UPMC, who were helping to manage his symptoms until transplant became his best treatment option.
It was several months later that he was diagnosed with liver cancer. Despite his regular appointments, this aggressive cancer had rapidly spread.
That meant that transplant was finally his best option—but maybe he was too sick.
“To me I was hearing that I was too healthy to be on the transplant list based on my MELD score, and too sick to be on the transplant list because of the aggressive nature of the cancer.”
After waiting for so long and after being treated with a round of chemotherapy, Michael underwent a transplant evaluation and was deemed a candidate for the liver transplant waiting list. But he was still sick, and the future was still uncertain.
He wasn’t sure if he would receive a deceased-donor liver transplant in time. He decided to search for a living donor.
The Solution: Finding a Donor in the Family
For patients who need a liver transplant, a living donor does not need to be a family member. But often people start by asking family members and that’s where Michael began as well.
Even before he was on the waiting list, Michael’s family was always supportive and attentive.
His daughter and his son-in-law, who is named Mike, both wanted to help. They just didn’t know how. It was hard to watch Michael get sicker, and even when he was physically healthy, they could tell that he was feeling anxious.
When they learned about living donation, Mike immediately decided to get evaluated.
“Getting the opportunity to help save someone’s life is pretty incredible,” Mike said. “We really cared for and loved Michael, so I jumped at the chance.”
It was a long journey, but Mike and Michael underwent a successful transplant surgery on August 9, 2018.
The Result: A Family Gains New Perspective
Both Mike and Michael said that recovery was not as bad as they had anticipated.
“It’s not an easy procedure,” Mike said, “There were some difficult days, but I expected that. I was prepared for it. Strong family ties helped us through it.”
After five days, they left the hospital. Throughout recovery they continued to support each other and to speak every day. The most powerful part of the process, for both of them, was how it changed their perspective on life. Michael is trying to enjoy life more, to let go of the little things that used to bother him, and to use his experience to educate others about living donation.
Michael said, “It was a tremendous act of courage for Mike to willingly put himself through that process to save someone else. It's an extraordinary gesture. I can't ever be thankful enough."
“This was an amazingly rewarding experience for me,” Mike said, “I feel sometimes that I got just as much out of it as Michael did. I consider it the best day of my life.”
Michael and Mike’s treatment and results may not be representative of all similar cases.