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Roll call for organ transplant list

Marine's need for a liver put him on an elite list: Those in dire need of an organ transplant

11:18 PM PST on Tuesday, February 1, 2005

By DOUGLAS E. BEEMAN / The Press-Enterprise
Awaiting organs

Thousands of Southern California patients with failing organs are waiting for a transplant. Here is the most recent waiting list (as of Jan. 28) for the region that extends from Kern County to the Mexican border:

Kidney: 6,580

Liver: 1,912

Heart: 362

Lung: 326

Pancreas: 75

Intestine: 17

Kidney-pancreas: 442

Heart-lung: 6

Source: United Network for Organ Sharing

Half of people with liver disease must wait two years or longer to get a potentially life-saving transplant -- if they get one at all.

Marine Lance Cpl. Chris LeBleu got his new liver in just weeks.

His status as an Iraq war veteran counted for little, organ procurement officials say. But they explained that his collapsing health and a fortuitous set of circumstances pushed him to the top of the recipient list when the liver of a 63-year-old woman became available in New Mexico.

LeBleu, 22, received the new liver Sunday at Loma Linda University Medical Center, two days after slipping into a coma. LeBleu remained in critical condition and in a coma Tuesday, although doctors are upbeat about his prognosis.

His physicians believe LeBleu may have contracted viral hepatitis that attacked his liver, although they don't know where he picked it up. More tests are being done to confirm the diagnosis.

LeBleu -- "Blue" to his fellow Marines -- returned to the Marine Corps Air Ground Combat Center at Twentynine Palms last September after seven months in Iraq. In mid-December, he complained of feeling ill, his wife Melany said. He brushed aside family pleas that he see a doctor.

By Jan. 10, he couldn't even keep water down, she said. That's when LeBleu was admitted to the base hospital at Twentynine Palms.

Last Wednesday, he was admitted to Loma Linda University Medical Center's Transplant Institute. By Friday, his condition had dramatically deteriorated: he was on life support and his brain showed signs of swelling. Doctors feared he might not survive the wait for a liver transplant.

Other Organs

Livers are the second most-needed organ after kidneys, said Annie Moore, a spokeswoman for UNOS, the United Network for Organ Sharing. UNOS coordinates transplants nationally. Half of all liver candidates wait 796 days or longer for a transplant, she said. Some never make it to the operating table.

Dialysis can sustain kidney-transplant candidates for years, and often, kidney patients must wait years to get a transplant, Moore said. Liver and heart transplant candidates have nothing similar to sustain them through the wait.

"When these vital organs shut down, you are facing a life-and-death situation," she said.

When a liver becomes available, a local-organ procurement organization will submit details about the donor's blood type, the organ's size and the donor's location to UNOS. With that information in its database, UNOS will produce a list of potential recipients ranked by greatest need, a match of blood types and proximity to the donor.

Geography is important, Moore said. The liver can survive outside the body for about 12 hours, which limits how far it can travel for a transplant.

As transplant coordinators work down the list, they may have to exclude transplant candidates who are too ill for the operation, have an infection that makes surgery problematic or who cannot get to a transplant center fast enough, Moore said.

As potential recipients are scratched from the list, transplant coordinators broaden their search to waiting recipients in other states or regions, Moore said. That's how a liver from New Mexico could end up in Inland Southern California.

In this case, no one else in a five-state area from New Mexico to California was as desperate for a liver as LeBleu, said Maria Sanders, spokeswoman for the New Mexico Donor Services.

Liver Donor

The liver came from Laralee Bergstrom, a 63-year-old woman from Littleton, Colo., who was fatally injured in a traffic collision outside of Santa Fe. After doctors declared Bergstrom brain-dead Saturday, her two daughters agreed to donate her liver and kidneys. The kidneys were given to patients in New Mexico, Sanders said.

Although Bergstrom was 41 years older than LeBleu, the age difference was less important than making sure the liver was functional, Sanders said. The condition of the organ depends on the type of life the donor led.

"From what we understand, this woman was pretty healthy for her age," Sanders said.

Bergstrom's daughters had no idea who got her liver until friends in California made the connection between her death and news stories about the young Marine receiving a transplanted liver, Sanders said.

"They said their mom would probably be ecstatic to know she saved the life of a 22-year-old," Sanders said.

Although LeBleu made an appealing candidate as a young Marine just back from a war zone, that was not a factor in deciding where he landed on the transplant list, organ procurement officials said.

"The urgency of need determines where someone is on the list," said Bryan Stewart, a spokesman for One Legacy, the transplant network serving most of Southern California. Several other people may have been just as ill as LeBleu, Stewart said. But blood types of the donor and recipient must match and the organ must be the right size to make the transplant possible, he said. Because the liver was donated in New Mexico, One Legacy was not involved in connecting the donated organ to the recipient.