Transplant Center

Patient Testimonials

"Domino" Liver transplant offers hope for two Maryland men

Russell Ward, left, (with his wife Dee) holds a medical identification bracelet given to him by Donald Guyton, right. Guyton's wife Louise is behind him.

Due to a unique type of transplant, one man’s diseased liver turned out to be another man’s cure.

Donald Guyton, 64, had a liver disease which was causing paralysis and eventually could have resulted in fatal heart damage. But for Russell Ward, 74, who was extremely ill with another type of liver disease, Guyton’s liver proved to be a lifesaver.

As part of a unique "domino" or sequential liver transplant, the first ever performed in Maryland, Guyton received a new liver from a deceased donor to cure his paralyzing disease. Then his liver was transplanted into Ward, who was suffering from liver failure. The simultaneous transplants took place in an 18-hour operation on May 19, 2005.

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Although Guyton's liver produced an abnormal protein, it worked well otherwise and would not cause symptoms of the disease in Ward for at least 30 years.

"Within three days of the transplant, I could feel all the difference in the world. It seemed like my body just came back," said Ward.

For his part, Gutyon was glad his liver was able to be put to good use, but is still somewhat in awe of the whole process.

"It was somewhat amazing that my liver was good enough to be used again," he said. "It's mind boggling but I’m glad there is a chance for this to be used. It’s humbling to think I was able to make that possible."

Guyton's daughter Tyra was also glad her father was able to help someone else. "I think it’s wonderful that they were able to re-use the liver. Here's a healthy liver that didn’t go to waste. And we were so thankful that somebody was able to donate to him. We wanted to be able to do the same thing for someone else."

Different Liver Diseases Led Men to Each Other

The two men had very different health problems, but both suffered from liver diseases that could have proven fatal.

Guyton, who has been an electrical contractor for 40 years, was diagnosed with familial amyloidosis last September after DNA testing. Symptoms first began to appear in his late 30’s, but at that time, no connection was made to the disease. He had tingling and numbness in his hands, and he began experiencing gastrointestinal problems. By his late 50’s, the symptoms included weakness, burning and tingling in his feet, and difficulty walking.

“Several years ago I started getting symptoms of weak legs, ankles, feet. Walking was down to a bare minimum, and I used a cane,” said Guyton.

The abnormal protein produced by the liver in people with familial amyloidosis is deposited throughout the body and eventually affects the nerves and organs such as the heart. Removal of the liver eliminates the source of the abnormal protein and halts the progression of damage.

“After the diagnosis of familial amyloidosis, we found out that a liver transplant could save my life. On the other hand, if my old liver stayed in place, the condition probably would have continued to progress and would eventually become fatal,” said Guyton.

Russell Ward, on the other hand, was very ill from steatohepatitis -- a disease that caused him to develop cirrhosis. About three years ago, Ward was told that he had the beginnings of liver disease, but that it would take some time before it became a serious problem. But then his condition rapidly worsened.

“It came on like a ton of bricks,” says Mr. Ward. In the weeks before the transplant, Ward was hospitalized repeatedly for confusion due to an ammonia buildup in the blood from his liver failure. “The disease was causing chemical imbalances that were totally wiping out my mind. I knew what I was talking about, but I couldn’t make you understand it,” said Ward.

Ward’s wife Dee says her husband was so sick he often didn’t recognize her and couldn’t always speak to her. “He didn’t even know me for a few days at a time .He was so confused. Sometimes he would try to talk to me and couldn’t, his words would slur. He couldn’t remember what he had said to me,” she recalled.

“I was getting to the point, I just wasn’t functioning and didn’t even know what was really going on,” said Ward

Ward finally came to the University of Maryland Medical Center after several doctors told him and his wife that there was no hope. “My doctor said with my age, my pacemaker, the health problems I had, just to forget it. But my wife wouldn’t take that for an answer.”

So after doing some research, Mrs. Ward found out about the University of Maryland and called to make an appointment.

An Extraordinary Solution

Eventually, Ward was placed on the liver transplant waiting list at the University of Maryland Medical Center (UMMC). But he knew his odds of getting a transplant in time were slim because of a shortage of donated organs and his age. Ward was on the waiting list for a live transplant. Meanwhile, his health was declining quickly.

A patient’s rank on the liver transplant waiting list depends on the MELD score (Model for End-Stage Liver Disease), a numerical scale ranging from 6 (less ill) to 40 (gravely ill) as determined by routine blood tests.

“Mr. Ward’s score was not high enough,” said transplant surgeon Benjamin Philosophe, M.D., Ph.D., head of UMMC’s Division of Transplantation and associate professor of surgery at the University of Maryland School of Medicine. “His only hope was something out of the ordinary.”

But an extraordinary solution came when the transplant team paired the needs of Guyton with those of Ward. In contrast to Ward’s concerns about a prolonged wait, the plan came together after he had been on the transplant list for just over three weeks.

“The domino procedure enabled us to help two very sick patients and make efficient use of the limited number of donor organs,” said Dr. Philosophe, who led the two transplant teams.

“We are very pleased that we could help two people with one liver,” added Dr. Campos. “This is a unique situation for both of them and we gave them the chance of a second life through an organ that normally gets thrown away. They’ve done very well so we’re very pleased about being able to save two lives with one organ.”

Life After the Transplants

Both Ward and Guyton feel their lives have improved dramatically after the operations.

“After the operation, I could feel the possibilities,” said Ward. “I feel wonderful.”

Ward’s wife also noticed a drastic difference. “It’s just like night and day. It’s like giving me back my husband,” she said. “I’m just so happy. I prayed every night for this and I got him back. For the first time since his operation he can really talk to me. Now he’s coming back, the same old Russell.”

Mr. Guyton is also doing well, although he did require another operation to repair a leaking bile duct. The bile duct is the structure that carries bile from the liver to the intestines.

Guyton says he is also feeling better since the operation. I’m feeling well,” he said. “It’s amazing.”

And Louise, Guyton’s wife now feels her husband has a new chance at life. “I feel that he is not going to die from this disease any longer and that we will have more quality time together,” she said.

A Special First Meeting

The two men had the opportunity to meet each other for the first time during a recent news conference at the Medical Center. Ward says he was glad to meet Guyton.

Ward says that he and Guyton will be in contact and “we’ll see how each other is doing. “I got his name and address and I’ll keep in touch with him.”

At conference, Guyton gave Ward a metal bracelet that identifies him as a transplant patient.

“It’s a bracelet that you have engraved saying that you’ve had a liver transplant,” Guyton explained to Ward, who briefly broke down in tears as he accepted the bracelet. He promised he would get the bracelet engraved.

Ward, who had previously worked as a building manager, says he is now looking forward to enjoying his retirement years and doing what he loves most -- camping, fishing and boating. Before the operation, he said, “I just didn’t see any tomorrow. Now I do.”

By Michelle W. Murray

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This page was last updated on: September 29, 2008.