Summer 1997
Catherine Koos was only 30 years old and virtually housebound—she was held captive by an intense, unexplainable itch which affected her entire body.
"I would stay home in a bathrobe for most of the day, hesitant to go out," said Koos. "The itch that I felt went all the way down to my bones." The persistent symptom prompted her to see numerous doctors, but they were unable to give her a diagnosis. After months of suffering, Koos finally was referred to Dave Stump, MD, a gastroenterologist, and Glenn A. Halff, MD, associate professor of surgery and director of the organ transplantation program at the Health Science Center, who provided her with some answers.
Koo's itch was the result of liver damage caused by an autoimmune disorder known as Sclerosing Cholangitis. The condition was causing her bile ducts to clog and become scarred. Eventually she would need a new liver.
While such news may have distressed some patients, Koos was relieved to know what was wrong and that there were treatment options. Newly married and a biology student at The University of Texas at San Antonio, she elected not to be placed on an organ transplant waiting list. Instead, she chose treatment for the clogged bile ducts. To allow for bile drainage, the radiology team at the Health Science Center surgically placed two tubes into her bile ducts. Called percutaneous transhepatic cholangio catheters, one exited from the right side of Koos' body between the last two ribs and the other from the middle of her abdomen. Both tubes drained into a bag which Koos wore on her body. The tubes were painful, irritated the skin and limited her activities. Every day she had the unpleasant task of emptying the bag and changing her dressings.
After two years of this routine Koos decided it was time for a new liver. "Dr. Halff never pushed me to get a new liver right away, and because of his attitude I had the time to digest the thought of getting a new liver. So when the day did come, when I couldn't take the tubes any longer, I told Dr. Halff I was ready," she explained. Koos was put on the organ donor recipient list in April 1995.
The expected waiting period for a donor liver is approximately six months. Koos said that amount of time passed quickly. But each successive month, she said, seemed like an eternity. Her optimism and faith, though, didn't waiver. "I never really thought of dying because of my young age and the fact it was just my liver that wasn't working," said Koos. "I was healthy in all other respects. I knew it would work out."
Nine months after being placed on the recipient list, Koos got a call from the transplant coordinator—a donor liver was available for her. In January 1996 she had the transplant surgery that would dramatically improve her lifestyle.
"I feel great. Now that I don't feel sick all the time, I feel free—free to start living again," said Koos. "Dr. Halff has been with me through my ordeal and he has been incredible."
"A complex program such as liver transplantation could not be this successful without the help of Dr. Robert Esterl, Dr. Francisco Cigarroa and the 20 other people who make up our team," said Dr. Halff. Dr. Esterl is assistant professor of surgery and Dr. Cigarroa is assistant professor of surgery.
"There are two key qualities that contribute to a patient's recovery and how well he or she does," said Dr. Halff. "One is a strong desire to live and the other is a supportive family." Koos has both. She especially credits her husband's support when she lived with the tubes. "My husband didn't treat me like an invalid. He encouraged me to live as normally as possible, and looking back, that was the best thing he could have ever done for me," she said. "It would have been so easy to just lie around and mope, but Al kept me on the positive track.
"Because of my second chance at life I know what's important and what's not, meaning I don't let the little things bother me," she added. "Life is too precious and too short."
