It’s not an unusual theme: a young person enters medical school determined to help save the world – or at least his or her small part of it. As doctors, men and women hold so much potential in their hands and while some go on to practice in the more traditional fields, others move on to more developing areas of medicine, like transplantation. While every doctor does affect lives, what transplantation surgeons and researchers do is, quite literally, give life back to someone who had no chance of survival before.
Jeffery Steers, MD, is one such transplant surgeon. After graduating from the University of Kansas Medical Center, School of Medicine with his MD, he went on to do a residency in general surgery, followed by a fellowship at the Mayo Graduate School of Medicine in surgery. His interest in transplantation, specifically liver transplantation, happened when he was looking after people with severe liver disease. “Watching them die, it made me feel helpless that they would die without replacing the organ,” he said. And, once Dr. Steers began participating in liver transplants, he said the changes in the patients were close to miraculous. “Where you had a patient who was dying, who had no hope, and you end up seeing him six or seven months after the transplantation, I don’t even recognize them sometimes. That was when I knew I wanted to do a fellowship in transplantation.
“That’s one of the other exciting things about this: seeing patients who went on to do something amazing things, knowing that you were able to play a small part in helping them get there.”
Dr. Steers is now head of the abdominal transplant program for Aurora Health Care. He’s based at Aurora St. Luke’s Medical Center in Milwaukee. Aurora Health Care is the largest not-for-profit health system in Wisconsin, with 13 hospitals and more than 100 clinics.
Being part of this process of giving back life has been part of Dr. Steers’ life for 20 years now and the changes in the field are making his job easier as patients are able to live better and longer with the care they are receiving. “The general medical care of patients before and after their transplants has dramatically improved – taking care of complications and preventing them from being a fatal problem, especially if we look at heart and lung transplants,” he explained.
With the heart, before there were ventricular assist devices – machines that help the heart to pump or take the place of the heart’s pumping action – it was difficult to manage people who had severe heart disease. Dr. Steers says, “I had one lady in her thirties who had heart failure. In a period of three months’ time, I admitted her four times. Now, there are some medical therapies that made a difference in how their heart works, so we can keep their heart working much better and if it fails, we can move on to ventricular assist devices, which are basically mechanical pumps to help blood through. And, as a last resort, we can do a heart transplant.”
The care has also improved to the point that the doctors and nurses don’t see some of the complications after transplantation that they used to. “We don’t even see the rejections for kidneys, or kidney and pancreas, or liver as we did 15 years ago.”
Who Can/Can’t Donate?
Believe it or not, not many people can’t donate anything at all. Age is definitely not a factor either in many cases. According to Dr. Steers, “I would say that it’s rare for someone not to be able to donate any organ, unless they have a disease that could be transmitted into the recipient. So the common situations are like cancer, that is active. There are several kinds of cancer that are easily passed from donor to recipient so we have to be careful about avoiding those.” Infections, like HIV, may rule out some donors, but not all infections. For instance, recipients who are hepatitis C positive can receive organs from donors who also had hepatitis C.
“Anyone who has seen the before and after would never doubt the value of transplantation.”
Dr. Steers also points out something that many people don’t think about. Donations and transplantations aren’t always about major organs, but also about tissues. Someone might not meet the requirements for organ donations, but their tissues may be usable. Body tissues can be used to repair injuries, heal burn patients, and even provide skin for someone who need breast reconstruction following mastectomies.
There are stories and patients you never forget in just about any field of medicine and maybe no more so in transplantation. When asked, Dr. Steers’ memory was about a child. “Before I came to Wisconsin, I practiced in Florida. We had several children who had died at amusement parks in Orlando. One particular one, I’ll never forget was a girl, 7 or 8 years old. She and her family were going to one of the amusement parks and it was her first trip there. She was so excited. They were standing at the spot to meet the trolley to take them to the park when she pulled on her moms hand and said, ‘I have a horrible headache’ and she just collapsed. Those are stories you just never forget. You carry those with you forever.”
You learn a lot about people when you’re a doctor. In transplantation, people who agree to allow their loved one’s organs to be donated may be asked some tough questions about their loved one’s health, even drug use. Dr. Steers explained, “When they’re donating their loved ones organs, we have to – of course – ask about drug use (IV drugs, cocaine, or anything else). It’s shocking the number of times we’ve asked this and they adamantly deny it, that this would never happen. And, we find their blood is positive for two or three different drugs.”
These situations are worrisome because the transplant doctors must try to ensure the health and viability of the donated organs. It’s not as if they have time to run lengthy tests, so they have to depend on the information they have on hand or can get from family members. “The hardest part is we’re expected to make a perfect decision based on imperfect information a lot of the times.”
The Gift of Donation
Dr. Steers has signed his donor card, as he wishes many others would as well. He said, “Donation is probably, short of sacrificing your own life for someone, the greatest sign of compassion and love that anyone could ever express. At a time when you’re experiencing a tremendous loss, to think of other peoples’ needs and what they can do for someone else, I think that there’s probably not a greater thing. It’s not easy.”
“I wanted to be a doctor since I was 6 years old. There are days when it’s tiring and frustrating, but I don’t regret it for a minute.”