Doctors: the patient I’ll never forget

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four doctors clipboards_oncology news australia_800x500By Sarah Smith – The Guardian.

Four doctors and their extraordinary patients tell their stories

Professor Nigel Heaton, 58, is consultant liver transplant surgeon at King’s College hospital, London. Steven Featley, 19, lives with his parents and sister in Stradbroke, Suffolk.

Nigel For 31 years, I’ve been seeing children and adults with liver disease. We’ve transplanted nearly 1,200 children, but Steven is the one who stands out. I’ve known him since he was a baby. He was born with a liver condition, biliary atresia, so was poorly within weeks of birth. The bile ducts in his liver blocked up, so toxins couldn’t be removed or fats digested. There are operations to try to correct this, but most children need a transplant.

Steven had his first transplant, from a brain-dead organ donor (a cadaveric), in 1995, when he was 14 months old. Little did I know that was the first of four I was going to conduct on him.

Quite soon after, he developed complications, so his mum gave him a fifth of her liver. Everything seemed all right, but a few years later he started to get problems. Another transplant followed.

By this stage, Steven had been through such a lot and I started to get worried about how it was all going to end. As a father of four [aged 24, 21, five and three], I’ve become much more emotional about transplanting children. The most difficult time was when we had to decide whether Steven should have a fourth transplant. This was a huge risk. It is rare to have so many; it means the situation is becoming more critical. And what about the patients waiting for their first transplant? How many livers should an individual be given? When do you stop? Is it inevitable he is going to lose the next liver that could help someone else?

I had found the problem, though – the outflow of the liver was compromised – so I felt it would be different this time. His prospects were good. I had to convince a team of 25 experts, from surgeons to clinical psychologists, who had mixed views.

As for Steven and his family, I’ve always found them realistic and accepting of even the worst things I’ve had to say. Steven is very intelligent and has great insight into his condition. He’s very dry, very funny. He’ll wake up after surgery and say, “I’m still here” or, “You haven’t got rid of me yet.”

Steven had to wait about a year to receive his fourth liver, 20 months ago, and the outcome is looking fantastic. He is the healthiest he’s ever been. He is returning to doing normal things and thinking about the future, which he hasn’t really done before. I hope and believe he’s now going to have a fulfilling adult life. That’s my reward.

Steven Every time I look at my stomach, I’m reminded of Professor Heaton…read more.


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