Column: Chicago doctor needs a liver to stay alive. His family friend, a young dad of 2, is donating 60% of his.

Chicago Tribune (IL)

Rick Foulkes has shared some big moments in Adam Laski’s life.

When Adam was a teenager working at Golf & Games in Woodstock, and he fell in love with Emily, his co-worker. When Adam and Emily, several years later, got married. When the young couple had their babies, who are now 1 and 4.

Now, Rick, 69, and Adam, 35, will share a liver.

Rick is married to Rita Rossi-Foulkes. Rita’s best friend since third grade, Janet Nern, is Adam’s mother-in-law.

Rita watched Emily, her best friend’s daughter, fall in love with Adam, a gentle sweetheart who now works as an operations manager for GoHealth, an insurance marketplace.

“He’s Mr. Help Everyone,” Rita said. “He’s always over at Janet’s house putting in air conditioners, taking out air conditioners, fixing everything.”

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Now Rita’s watching Adam help save her husband’s life.

Rick has liver cancer. It started as a neuroendocrine tumor on his pancreas, which a University of Chicago radiologist first discovered in 2008. Rick, an ophthalmologist, underwent three surgeries, targeted radiology, hormone therapy and chemotherapy. But the cancer grew and spread to his liver, which is now riddled with tumors.

A University of Chicago hepatologist recommended Rick consider a liver transplant. Otherwise healthy — he was an endurance athlete until chemo slowed him down; he doesn’t have jaundice — Rick’s a good candidate to receive a portion of a living donor’s liver.

That means he’s not at the mercy of a MELD (Model For End-Stage Liver Disease) Score, which prioritizes patients to receive deceased donors’ livers based on the severity of their liver disease.

It also means making a brave, big ask.

“It’s a very odd thing to ask another human being to give you a piece of themselves,” Rick told me in March, when I first wrote about his search for a donor. “And it’s not just like giving a unit of blood. It’s a big deal. If I were to cause harm to someone so that I can dance around for the next 5 to 10 years ... it’s hard. I don’t know how you escape that.”

Live liver donation is considered very safe, and the risk of injury or death is extremely rare.

The world’s first successful living donor liver transplant took place in 1989 at the University of Chicago, when a 29-year-old Texas woman named Teresa Smith donated a portion of her liver to her 21-month-old daughter, Alyssa. Alyssa suffered from biliary atresia, a fatal liver disease, at the time. In 2010, Alyssa graduated from college with a bachelor’s degree in social work.

“A lot of our recipients really struggle to ask somebody,” said Dr. Anjana Pillai, a University of Chicago gastroenterologist and transplant hepatologist on Rick’s transplantation team. “They think, ‘How can I put another person in danger?’ What we tell our patients is that most people who want to donate want to do it out of the goodness of their hearts. It’s something they feel they can contribute to society.”

Adam knew he wanted to throw his liver in the ring, so to speak, as soon as he learned Rick was a transplant candidate.

“I told Emily, ‘I think I could do this,’ ” Adam said. “I had a feeling I could at least go on this journey. I didn’t know if I’d get to stay in it to the end, but I could at least start.”

He knew his blood type matched Rick’s. A thorough physical and MRI and EKG and biopsy and 3D print of his liver revealed no red flags that would signal a poor outcome for either of them.

Adam is smaller in stature than Rick, which could have been a problem. Rick and Rita’s daughter wanted to be the donor, but was deemed too small to qualify.

“I’m 6-foot-5, so my liver’s a little bigger,” Rick said.

The portion of his donor’s liver has to be big enough to filter and process and do all the liver functions Rick needs it to do while it regenerates to full size — a process that takes a few months.

But Adam’s medical team — which works separately and independently from Rick’s — agreed with Rick’s medical team that Adam’s liver was large enough to sustain Rick. The surgery, both families learned just a few days ago, is a go.

“I can tell people, ‘I might be 5-foot-8,” Adam joked, “‘but liver-wise I’m 6-foot-5.’”

On Thursday, doctors will remove about 60% of Adam’s liver and transplant it into Rick. Within a month, Adam’s remaining liver is expected to regenerate to 80% of its original size and function. It will continue to grow from there. He has to avoid lifting heavy objects (including air conditioners) for 3 months or so to prevent a hernia. He should be able to return to work within two weeks of the surgery.

Rick will be on a series of immunosuppressing drugs to keep his body from rejecting Adam’s liver. He’ll take medication to help prevent the sort of fungal, viral and bacterial infections that his suppressed immune system could fail to ward off. His doctors will, of course, have to screen him carefully to make sure his cancer doesn’t return.

The road ahead won’t necessarily be smooth. Or linear. But it’s paved by the sort of kindness that Rick has always believed in and taken care to witness.

“This is so emotional for me,” Rick told Adam on a recent Friday night, wiping back tears. “I just can’t tell you, man. Everything you’re doing for me. It’s insane. I just cannot thank you enough. To put yourself through this.”

Adam rose to his feet and embraced Rick.

“I would do it every time,” Adam said.

“It’s a lot,” said Rita, who is a pediatrician and internist. “I’ve got two people I love going into the operating room. I have every confidence. I know they’re going to do well. But it’s just a lot.”

Adam waves away any accolades.

“People are like, ‘Oh, I can’t believe you’re doing this,’” he said. “If this was your son, if this was your daughter, if this was your friend, I think you’d do the same thing. I think people sell themselves short.”

Even if his liver wasn’t a match for Rick, he said, he was planning to keep his name on the donor list for someone else who could use it.

“Now that I went through the process, now that I see who I could save, I told my wife, ‘I’ll do this for someone else,’ ” Adam said. “Yeah, you might have three months of inconvenience. But you save a life.”

Rick has met other liver disease patients throughout his ordeal, and he finds himself evangelizing for the process — encouraging others to go public with their need for a liver, to talk to their medical teams about whether they’re eligible for living donation.

“I very much want to be a poster child for the possibility that maybe you don’t have to be all the way to death before you have a chance to be living your life again,” he said.

When Rick and Rita first started searching for a donor, they turned to Facebook and Twitter. They came up with hashtags: #liverforrick2021 and #allyouneedisloveandaliver.

I was struck, at the time, by the incongruence. Here were two doctors, immersed in the lifelong study and application of medicine and scientific advancements and procedures, pinning their hopes on an unknowable, fickle resource: Human kindness.

I love that they found it. And not just in Adam. Rick said they heard from people all over the nation after I wrote about them in March — strangers who wanted to help, who were willing to endure quite a bit to help.

“It’s very humbling,” Rita said Friday.

“As much as I know that, inherently, people have this desire to do something important with their lives, this has absolutely taken it up a notch,” Rick said. “To have people come through in this way, it’s really something. It’s really, really something.”

And, hopefully, the beginning of something else — long, healthy lives for Rick and Adam, first and foremost. But also a growing awareness about the power and beauty and possibility of living donation.

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