A woman from Lake of the Ozarks has a new lease on life thanks to a liver transplant in December at Barnes-Jewish Hospital. The liver she received had been declined by other transplant centers before it arrived in St. Louis.
Bobbie Bridges was 46 in January of 2023 when she started experiencing problems with her liver. That followed a bout of COVID and then abnormal blood tests that led to Bridges having to have blood transfusions. On January 17 last year, she was at work.
“I was helping with youth, and I started feeling really weird," she said, "and so I had my parents take me home. And the next morning I got up to go to work, and I go to work and everyone was like, 'you look like a Simpson, and you probably need to go to the doctor,' and I was able to get into my doctor, and she said, 'go to the E.R. You're really sick.' And I didn't leave the hospital for like three months.”
Her health began improving shortly after, and she says she was feeling pretty good, but in June, things took a turn for the worse. She was having weekly paracentesis to remove fluid from her body and was in and out of the hospital constantly, including a stay at Barnes-Jewish Hospital last August. On her birthday, September 27, she was placed on the transplant list for a new liver.
Her MELD score – which helps determine a person’s place on the liver transplant list – was high enough to place her toward the top. But, those scores began to improve.
“I was still really, really sick. And that causes you to go further down the list," she said.
Soon after, Bridges learned about a technique at Barnes-Jewish that is used to make previously unviable livers viable. Her doctor asked if she’d be open to receiving one of those livers, and she said ‘yes.’
Dr. William Chapman, a Washington University transplant surgeon at Barnes-Jewish, is working to recover and restore livers that have been rejected by other transplant centers. Normothermic Machine Perfusion or NMP is used to treat the organs and increase transportation viability.
In a normal transplant scenario, he explained, an organ is flushed with preservation solution and iced to slow the metabolic rate. But any delay in getting the organ from the donor to the patient can mean it’s rejected by a transplant center. He said some livers are declined due to things like fatty infiltration, a problem they’re seeing more of, "especially with our diabetes and obesity epidemic basically in the U.S. And so, if there's fatty infiltration in the liver, that can make that organ very difficult to — when it's placed back in the recipient it's a big stress load on the liver and on the recipient. That’s just one example.”
This new technique is salvaging some of those organs.
“So, basically the liver is recovered from the donor just as we always have done, Chapman said, "but then it is placed on a perfusion device that perfuses the liver with a blood-based perfusate. So, it's not exactly like blood, but it has nutrients and hormones — things that the liver needs for function, and it’s oxygenated.”
Chapman has been involved in testing one particular NMP device since 2019, the OrganOx metra. And he said he’s pleased with how things are going so far. Recent numbers show Barnes-Jewish has had a 73% liver rescue rate. Of 60 declined livers in the RESTORE trial at Barnes-Jewish, 22 met the standards for NMP treatment. Sixteen of those passed viability testing and were transplanted into recipients.
Not long after agreeing to receive a recovered liver, Bobbie Bridges got the call on December 19 that one was available for her. She and her husband immediately headed to St. Louis, and the next morning she underwent surgery to receive her new organ. During recovery, she stayed at Mid-America Transplant House, which she said provided her a restful, peaceful space close to her doctors.
Recovery is ongoing, but Bridges said she’s doing really well.
“I was in bed for three months before my surgery," she said, "and so, when I felt better, I just — I felt so much better. I was like, 'I've just got to get up. I've got to get up, I've got to get out of this bed.' And I'm still trying to recover from everything, so the patience has been the hardest."
Shortly before she got sick in January of 2023, she was preparing to begin teaching her own preschool class of three and four-year-olds. Her illness left her unable to work.
She’s just beginning to think about her future again and doesn’t know yet if she’ll go back to teaching. Her granddaughter recently started kindergarten, and she’s looking forward to volunteering at the school.
“I’m going to just kind of let things unfold as they're going to," she said, "because it's unfolded in such a crazy and extremely blessed way now that I'm just kind of waiting to see what’s going to be in the future.”
Dr. Chapman expects NMP to allow more patients to have a future.
