Patient with rare liver condition second ever to survive liver transplant after pregnancy

Apr 23 2005

For Billi Tierney, 30, National Donate Life Month in April has a profound meaning. The first-time mother of Sycamore, Ill., was awaiting anxiously the arrival of her first baby. But she never thought that complications from her pregnancy were going to lead to a week in coma and the urgent need for a liver transplant. Tierney suffered from acute liver fatty of pregnancy, a rare, but serious condition of pregnancy in which there is an excessive accumulation of fat in the liver or liver cells.

“Eighty-five percent of these patients recover without the need for a liver transplant,” said Dr. John Brems, chief of intra-abdominal transplantation at Loyola who was responsible for Tierney’s liver transplant surgery. However, 15 percent of patients with acute liver fatty of pregnancy die.

Acute fatty liver of pregnancy occurs in about 1 to 7,000 to 11,000 cases. The United Network for Organ Sharing (UNOS) reports seven women requiring a liver transplant for this condition. Four of these women died between six and 30 days after the transplant. One was lost to follow up (unable to contact). According to UNOS, only two patients have ever survived the condition after a liver transplant and Tierney is one of them.

Tierney delivered Jaxon by caesarean section on Jan. 24 at 35 weeks gestation (40 weeks is considered a full-term pregnancy) at another health-care institution. Doctors there realized her liver was not functioning properly after delivery. The medical team decided then to transfer Tierney to Loyola.

The same day Tierney delivered Jaxon, she was airlifted to Loyola. “I was able to hold Jaxon for a few minutes in the neonatal intensive care unit before I went to Loyola,” Tierney remembers. “After that, I was unable to see him for a month when I finally came home,” Tierney says.

When Tierney came to Loyola, she was in a coma for about a week. She had profound liver failure, so she was put on a ventilator for a few days while she was treated with medications. Her condition worsened, and she was placed on the organ waiting list on Feb. 2. Her liver transplant became a reality on Feb. 4. “That week, two lives were born – Billi through her new liver and her son,” Brems said.

Tierney still recalls when her husband came to visit her at Loyola with images and photos of their son. Even her family placed photos of Jaxon in the wall of her room at Loyola to show her his progress.

The first-time mother plans to send a letter to the donor family to let them know how much she appreciates this second chance at life. “It has given me the opportunity to be a mother and have a family,” she says. “Life is so precious and sometimes we take things for granted,” Tierney reflects. “I have learned to cherish every day and refocus on what is really important in life.”

Tierney, her husband, Ted, and son Jaxon, will attend a candlelight ceremony at Loyola University Medical Center to honor the life that gave her the opportunity to enjoy her son. The ceremony is on April 14, 2005, at 4 p.m. in the Paul V. Galvin Memorial Chapel. The address is 2160 S. First Ave., Maywood, Ill.

Loyola University Health System is one of the leading solid organ transplant centers in the country, offering state and national transplantation programs including heart, heart/lung, lung, bone marrow and corneal transplant divisions, as well as an intra-abdominal organ transplantation division that offers kidney and liver transplants. Loyola is the only hospital in Illinois that transplants most solid organs and tissues.