Woman celebrates 3-year ‘liver-versary’ after unique transplant surgery

Liver transplant patient Jessica Maher
Three years after her liver transplant surgery, Jessica Maher is enjoying life with her husband, family and friends.

Jessica Maher’s ultrasound was supposed to show why the healthy 31-year-old was having chest pains. What her doctors found was alarming, though it had nothing to do with her pain.

“The whole left side of my liver was riddled with tumors — more than they could count,” Maher said. ‘It was an accident that the ultrasound caught this, and that they saw it.”

Maher was diagnosed with intrahepatic cholangiocarcinoma (iCCA), a rare form of cancer of the bile ducts inside the liver. Her next few years were filled with chemotherapy treatments, surgeries and illness. Her skin and the whites of her eyes turned yellow (jaundice), and her condition steadily declined.

Maher’s only hope was a liver transplant. But transplant surgery isn’t an accepted option for iCCA patients because of historically poor outcomes and increased risk of recurrence. Only a few hospitals in the country will even consider doing it. Additionally, donor livers aren’t readily available, and many insurance companies won’t approve the surgery because it’s considered experimental.

Treating a cancer that was deemed "untransplantable"

One night, Maher was chatting in a Facebook group for people with cholangiocarcinoma when someone mentioned the University of Chicago Medicine’s transplant program. She learned UChicago Medicine was expanding its liver tumor and adult living donor transplant programs to focus on cancers previously deemed “untransplantable,” including iCCA and colorectal cancer with liver metastasis.

The whole left side of my liver was riddled with tumors — more than they could count.

Even if UChicago Medicine didn’t choose Maher’s case for liver transplantation for her iCCA, the hospital had several clinical trials with unique chemotherapies that might help her. That’s because it’s a longtime National Cancer Institute-designated Comprehensive Cancer Center, the gold standard of comprehensive cancer treatment.

Due to liver damage from prior treatments, Maher was chronically ill and had been frequently hospitalized with only months to live. She reached out to UChicago Medicine liver transplant specialist, surgeon and co-director of the Transplant Institute John Fung, MD, PhD. She flew in to see him from her home outside Philadelphia and shared her story.

Fung consulted with his multidisciplinary team and determined Maher was a good candidate for the liver transplant surgery. Her tumors were stable, and the cancer hadn’t spread outside her liver.

Using a protocol that incorporated important new advances in staging, neoadjuvant therapy and immunosuppressive management, Maher was approved for the liver transplant by her insurance company. She also would be given priority for a donor due to the degree of liver damage.

Jessica was so sick, but now she is this beautiful woman living her life.

Some in the medical field don’t believe transplants like these should be done, given that the cancer is likely to come back. Fung disagrees. Of the six iCCA patients whose livers he’s transplanted, five are still disease-free and one has had just mild recurrence.

“Recurrence is not necessarily the end,” Fung said. “You can manage the cancer afterwards.”

At the forefront of transplant oncology

Transplant oncology is still fairly new and involves liver transplants for patients who were previously not considered for transplantation. UChicago Medicine’s Liver Tumor Program, directed by transplant hepatologist Anjana Pillai, MD utilizes a multidisciplinary team approach to identify patients who may benefit from liver transplantation, like Maher.

She underwent the nearly 17-hour surgery at UChicago Medicine in 2017. She spent the next month in the hospital, and her long recovery was complicated by a bile leak, a blood clot and bowel surgery. She lost 25 pounds and needed physical therapy to restore her atrophied muscles.

Jessica Maher recovering after liver transplant surgery

It was all worth it, Maher said, while celebrating her 3-year “liver-versary” this summer. Today, the 39-year-old is back to work in a medical device company’s marketing department, plays tennis, does yoga, and enjoys time with her husband, family and friends.

“Jessica’s case is really what made me look at these cancers from a different lens. She was so sick, but now she is this beautiful woman living her life,” Pillai said. “We know recurrence occurs, but she got three more years than she would have without the transplant, and hopefully many more.”

Jessica Maher, three years after her surgery

Fung and Pillai want to continue developing the transplant oncology program so it keeps UChicago Medicine at the forefront in this field.

“We’re cautiously optimistic that we’re making some headway in this area,” Fung said. “If we’re very thoughtful about it, and choose the right patients, we can make a big difference.”

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