House speaker gets a liver transplant; Michael E. Busch undergoes surgery, receiving tissue ; from his sister; full recovery expected in seven weeks

Maryland House Speaker Michael E. Busch, one of the state's most powerful political leaders, underwent a liver transplant Thursday to resolve ongoing health problems he has attributed to skin cancer medication.

In a brief interview with The Capital on Wednesday, the Annapolis Democrat said his health had taken a turn for the worse in recent weeks.

Busch's physicians at the University of Maryland Medical Center diagnosed him with nonalcoholic steatohepatitis, a form of liver disease, and determined in May that it was progressing.

At that point, Busch said he and his doctors decided on a liver transplant through the hospital's living donor program. His sister provided the donation.

The speaker's chief of staff, Alexandra Hughes, said Thursday evening that Busch was out of surgery and recovering.

Busch, 70, downplayed his health problems earlier this month when he filed to run for re-election as a delegate in District 30A. He said Wednesday his doctors told him he can expect a seven-week recovery period.

The speaker was upbeat about his surgery and the prospects for regaining his health. One of his daughters recently graduated from college and the other has completed her freshman year. Both are planning to spend the next few months at home with Busch and his wife, Cindy, during his recuperation.

"It's good that they'll be home this summer," he said.

As word of the apparently successful surgery spread Thursday night, those who know Busch wished him well. His office sent an email with details to members of the House of Delegates just before 7 p.m.

"Liver surgery is obviously very serious," Anne Arundel County Executive Steve Schuh said. "My understanding is that it went very, very well, and in fact it could not have gone better."

Busch's fellow presiding officer, Senate President Thomas V. Mike Miller Jr., D-Prince George's, sent him well wishes.

"I wish him the very best and hope for a speedy recovery," Miller said in a statement.

Busch, who is the longest-serving speaker in Maryland history, had previously brushed aside concerns about his health. He has lost a significant amount of weight in the last year, a complication from what he described as internal bleeding caused by medication prescribed to treat skin cancer on his legs.

When he filed paperwork to seek another term May 19, Busch said he was on the mend and hoped to be back to full strength by the fall.

In a statement released by his office Thursday, Busch acknowledged the situation has changed. He said he remained lethargic after a brief hospitalization last fall. In the final days of the General Assembly session in April, he could be seen taking brief breaks from floor proceedings.

Even in announcing the surgery, Busch made a political point in a veiled reference to ongoing Republican efforts in Washington to roll back the Affordable Care Act.

"Major surgery of this nature is always daunting," he said in the prepared statement.

"Unlike many in our state and our country, I am fortunate to have good health insurance and access to the best medical care in the country. This is the first significant medical issue I have had in my life and it does force you to reflect on those who may not have the same quality of care that many of us are blessed with."

Doctors labeled Busch's liver issues idiopathic, meaning that their cause is unclear.

Nonalcoholic steatohepatitis, also called fatty liver disease, is a condition in which fat builds up in the liver, causing inflammation and damage to the blood-filtering organ. While the disease shares symptoms with liver problems caused by alcoholism, Busch's diagnosis means his condition is not related to drinking.

The University of Maryland Medical Center has the largest liver transplant program in Maryland and is the third busiest liver transplant center in the country, according to information provided by the hospital. Last year, surgeons at Maryland completed 169 liver transplants.

Dr. Stephen Bartlett, who serves as executive vice president and surgeon-in-chief of the University of Maryland Medical System, said the outcomes for liver transplant patients, particularly those receiving an organ from a living donor, are overwhelmingly positive.

"The reality is 95 percent (of the surgeries) go flawlessly," he said.

In a living donor transplant, a family member or close friend donates a piece of their liver to be implanted into the person suffering from liver disease. According to information from UMMC, the recipient's body is more likely to accept a living donor's organ. The arrangement can also cut down on wait time for the surgery and result in a quicker recovery.

Because the surgery can happen sooner, "the effect is that the newly transplanted liver is not going into someone that is in a deteriorated condition," Bartlett said. "Typically, people get back to steam between eight and 10 weeks. They might be taking meetings sooner than that."

Because Busch's sister is the liver donor, doctors will be monitoring the transplanted organ's growth to make sure it is big enough to support his body.

Busch said during the interview Wednesday that he was looking forward to resuming normal activities as he recovers from the surgery through the summer.

"I will face this challenge in the same way that I have fought for the people of my district: with determination and hard work," he said in the statement released by his office. "I will keep working through my recovery and I look forward to spending time with my family and getting back on the lacrosse field with my daughters; jogging with my dog; and working for the people of Annapolis."

Busch was elected to the House from then-District 30 in 1987, and succeeded his mentor Cas Taylor as speaker in 2003 after the Western Maryland delegate lost his seat.

As speaker, he is one of the most powerful figures in Maryland government, along with Gov. Larry Hogan, a Republican also from Annapolis, and Miller. He has long been seen as a fierce advocate of increased spending on public schools.

His dedication to Anne Arundel County has won him praise from leaders of the county's Republican establishment, including Schuh and House Minority Leader Nic Kipke, R-Pasadena.

Over the years, Busch has been responsible for additional funding for renovations at Annapolis High School as well as a since-abandoned grant program to provide extra compensation to attract teachers to the most challenged county schools.

But he also has been a highly partisan figure who is a frequent target for Republican campaign efforts. He was recently interviewed as part of a lawsuit challenging Maryland's 2010 legislative redistricting process of congressional boundaries.

Former Gov. Martin O'Malley has acknowledged Democrats drew the state's convoluted congressional districts with an eye toward ousting a longtime Republican incumbent representative and replacing him with a Democrat.

The acknowledgment that state Democrats were working in 2011 to add a seventh member of their party to the House of Representatives, widely understood at the time but seldom conceded publicly even now, comes as Hogan is advocating for a nonpartisan redistricting commission, ostensibly to curb partisan gerrymandering.

Although Busch represents a district and a county that is divided among Republican, Democratic and independent voters, he is the leader of progressive Democratic majorities made up of delegates from Montgomery and Prince George's counties, as well as Baltimore city.

What the surgery means for his political future is unclear. He already is facing opposition in 2018. So far, two Republicans - former congressional candidate Mark Plaster and newcomer Chelsea Gill - have registered to run in the two-seat District 30A, which represents Annapolis and part of the Broadneck Peninsula.

Del. Herb McMillan, an Annapolis Republican who has represented the district alongside Busch for nearly a decade, is considering a campaign for the District 30 state Senate seat, which long-serving Democratic incumbent state Sen. John Astle is expected to vacated as part of his campaign for mayor of Annapolis. Former Republican Del. Ron George has already filed to run for Astle's seat.

Schuh, a Republican who has found himself both opposed to Busch while a member of the House and allied with him, predicted Busch would return to form.

"I am very confident that he will recover fully and be the vigorous speaker we have always known him to be," he said.

In addition to working as the House speaker, a job that extends beyond the 90-day legislative session in Annapolis, Busch is a deputy director of Anne Arundel County's Department of Recreation and Parks. Schuh confirmed that Busch has taken a leave of absence from his job.

Cards and messages can be sent to Busch's office at State House H-101, Annapolis, MD 21401, or by email to [email protected].

Credit: By Rick Hutzell ; Amanda Yeager - [email protected];ayeager@

Caption: Busch