Patient from Denver Double Lists, Gets Second Chance at Life
One of the benefits of living in Denver is the accessibility of the great outdoors. Anna Giovinetto, an avid cyclist and hiker, moved to Colorado to pursue an active lifestyle. Her interest in fitness blossomed and she was known to go on 100+ mile bike rides.
Slow Beginnings, Limited Options
In 2002, Anna was diagnosed with primary sclerosing cholangitis (PSC), a disease of the bile ducts that slowly causes bile to build up in the liver and damages the liver. Anna did not show any symptoms for a long time, but in 2015, the effects of PSC started taking a toll. She noticed that she was unable to stay fit and was tired all of the time. Despite working out and eating well, she could not keep up with her training.
She went to see a hepatologist and was placed on a liver transplant waiting list. Her blood work indicated that her MELD score (used to rate the severity of a person’s liver disease) was not high enough to hold a place near the top of the wait list in Colorado—she would potentially have to wait years before her condition worsened to the point that her MELD score rose high enough for her to get a transplant.
Waiting around to get sicker was not an option for Anna, so she decided to look into double listing, which means getting put on the waiting list at another transplant center where the MELD score needed to get a transplant may be lower.
“I heard about double listing from my hepatologist in Denver. It isn't something that's possible for everyone. You have to be able to relocate so you can be close enough to the other hospital to get there at a moment’s notice,” Anna recounts.
Through online research about her condition and about double listing, Anna found UMMC. She scheduled an eVisit with Steven Hanish, MD in January, 2017.
“Given Anna’s condition, I was confident she would be able to get a transplant faster if she listed at UMMC. After the initial eVisit, I recommended she double list at UMMC and stay in Maryland for a couple of months,” Dr. Hanish said.
Luckily, Anna’s parents live in Maryland. She and her boyfriend drove across the country and arrived for an in-person consultation with the UMMC team on February 9th. Just 3 days later on February 12th, Anna received a call from one of the nurse coordinators. They had a liver for Anna.
Bridging the Gap
A couple of days after a successful transplant surgery, Anna’s new liver unexpectedly developed large blood clots, and after about a week, it failed and had to be removed. The team had to act fast to stabilize her.
For extremely sick patients like Anna, UMMC offers the MARS machine, short for molecular adsorbents recirculation system.
“This state-of-the-art ‘liver dialysis’ machine simulates a healthy liver by removing toxins from the blood. With this technology, we’re able to provide more options for severely ill patients and make sure they have the best possible outcomes,” said Rolf Barth, MD.
MARS kept Anna alive long enough for another liver to become available. On February 22nd, Anna underwent another surgery to replace the first liver with a healthy one.
Back on Her Feet
Six weeks after she arrived, Anna was ready to leave the hospital. She transferred to UM Rehabilitation & Orthopaedic Institute for ten days. The physical therapy team there had her on her feet the first day, and she was walking by day five.
Now, Anna is back in Denver and sees a doctor there for follow-up care. She is full of energy and back putting miles in on the bike. In August 2017 she celebrated her six-month “liversary” with a cycling trip in Washington State’s San Juan Islands, riding 110 miles and climbing more than 9,000 vertical feet in three days.
Denver has its perks, but Baltimore (and UMMC) will always have a special place in Anna’s heart.
“I really gave the transplant team a run for their money! The doctors were really attentive and communicated well. Even when things looked dicey, I never doubted that I was in the best hands,” Anna said. "It's wonderful to feel well again, and to be able to do the things I love."