"The Walking Miracle"
David's Liver Transplant Story
David Hooper never could have imagined that a fall during a Sierra Foothills hike at age 19 would ultimately lead to him clinging for his life 36 years later. But that’s exactly what happened when David, a doctor and health care executive from Fremont, Calif. developed hepatitis C and then liver failure.
David's liver disease developed as a result of hepatitis C contracted from 6 units of blood he received in 1975 after his hiking accident. Back then, blood products didn’t undergo the rigorous screen for viruses that they do today. The hepatitis virus was dormant in David’s body until a few years ago when he developed liver failure.
Liver Failure - and then Panic
In spring 2011, David developed hepatopulmonary syndrome due to liver failure. This condition—which occurs when one’s liver disease advances to affect the lungs—causes low blood oxygen levels and shortness of breath. A few months later, David had a massive gastrointestinal bleed, vomiting large amounts of blood and requiring fluids and blood products to keep him alive.
"I was the most panicked that I hope I will ever be in my life," says Lynda Hooper, David's wife of 10 years. A nurse and hospital executive, Lynda was still rattled by her husband’s condition. She called 911 and the ambulance took David to California Pacific Medical Center (CPMC). Upon arrival, Lynda doubted whether David could survive after losing so much blood.
Doctors at CPMC performed an interventional GI procedure which, according to Lynda, saved David’s life. "He had lost a total of 4.5 liters of blood—the human body only holds about 5 liters," explains Lynda.
While the GI procedure stopped his bleeding, David's medical journey was just starting. He desperately needed a liver transplant to overcome the ravages to his body resulting from liver failure. "As the days dragged by during our wait for a liver, David grew sicker and more uncomfortable," says Lynda. He developed respiratory and kidney failure, and was under heavy sedation.
Grateful for a Transplant
On August 7, 2011, David’s family learned that a liver was available for transplant. "As he went into surgery at midnight, Dr. Hisatake told me that I’d receive a call at 7 a.m. when the operation was complete—or sooner if there was a concern. Just after 5 a.m. my phone rang and I was told that my husband was very, very, very hard to transplant due to his severe bleeding," Lynda explains. Because his veins that connected to his liver were so stretched and fragile from the hard and failing liver, once they were clamped for transplant, they bled profusely. It was a life or death situation.
The surgeons ultimately stopped the bleeding and David received a new liver. When they spoke with Lynda following surgery, she was told that three liver surgeons were stitching as fast as they could for more than three hours to save David’s life. "They had to keep calling additional surgeons in the middle of the night to come and help," says Lynda. "I was amazed at the liver team’s compassion and commitment to our case. It was unwavering, throughout every challenge that presented itself."
Again, David required an extraordinary amount of blood products to help him through his surgery. He was helped by the generous donation of individuals who give blood. During surgery David received 87 units of blood products including 48 units of fresh frozen plasma, 31 units of packed red blood cells and 15.7 liters of washed and recycled blood. "Again, the human body only holds about 5 liters of blood," marvels Lynda.
In addition to their gratitude towards blood donors, David’s second chance at life also came from his liver donor. "We are eternally grateful for the family who made the decision to donate the life-saving liver David received," says Lynda.
A Post-Transplant Tsunami of Complications
While Lynda and David thought they were out of the woods, two days after transplant they learned that David had pulmonary hypertension. "I knew that no one had ever survived a liver transplant with pulmonary hypertension—and David now had severe pulmonary hypertension," explains Lynda. Over the next two weeks, David’s condition significantly worsened and his medical team was considering taking him back into surgery to install a ventricular assist device since his right heart was failing.
"As part of evaluating David in preparation for surgery, we had what was later termed a '21 Gun Salute'" recalls Lynda. "There were 21 extremely talented, skilled, caring and knowledgeable providers discussing the case together to determine next steps." Ultimately, one of the anesthesiologists suggested testing a medication regimen never before given to patients with pulmonary hypertension. But it was a last resort and doctors were hopeful it may work.
"During the intense hours and days that followed, it was hard to conceive how David would survive this ordeal," recalls Lynda. "It was when the lead cardiologist in charge of the case stayed at his bedside for 11 hours straight to adjust medications every minute that I realized I needed to start planning David’s memorial service." Lynda could barely fathom that David would live as he was connected to 12 IV machines, on multiple medications including ones for cardiac shock, an insulin drip, chest tubes in both lungs, a nasogastric tube to provide nutrition, and artificial life support.
"Throughout all this, I was most impressed with the CPMC transplant team," recalls Lynda. "They never gave up. I mean never, never, never gave up. Even in the face of 100% certain mortality that is indicated in literature for this type of case, they continued to commit every resource, every skill and every expertise possible to save David’s life."
Amazingly, David’s pulmonary hypertension diminished and then disappeared over the coming weeks and David's health slowly improved. "The miracle we witnessed was definitely due to the clinical excellence of the CPMC transplant team," says Lynda.
The Hooper 9/11
But their ordeal wasn't over. On September 11th, about a month after the transplant, David's blood pressure plummeted, his heart rate spiked and blood started to ooze from his transplant incision. David was losing blood—again—and doctors had to infuse bag after bag of blood products. He was whisked into the OR where doctors found an infection undetected on CT scan that was causing a massive internal bleed. Surgeons used a few stitches to make the life-saving repair to the artery that was pouring blood into David’s abdominal area. For a fourth time in two months, David's life had been saved.
During his recovery, David endured a pneumonia complication that caused excruciating pain and difficulty breathing. He endured this for two weeks, then gradually began physical and occupational therapy.
One-hundred days after his hospital admission, David—referred to as a "walking miracle" by staff—was transferred to the acute rehabilitation unit. "He made amazing progress and recovered much faster than expected," says Lynda. Ultimately he was discharged home on 11/11/11, a day of "new beginnings."
Clinical Excellence—Each and Every Day
"When we returned to CPMC’s Liver Clinic for follow-up appointments, our medical team would simply sit and stare at David," says Lynda. "Everyone is amazed that he survived his ordeal." But, Lynda explains, the true underlying story they witnessed during their 100 days of hospitalization is CPMC's amazing teamwork, dedication, compassion and commitment to patients. "CPMC's liver transplant team provides this unparalleled devotion every day, for every patient. They don't give up—ever."