Liver Transplant

Ana Puente was an infant with a liver disorder when her aunt brought her illegally to the U.S. to seek medical care. She underwent two liver transplants at UCLA Medical Center as a child in 1989 and a third in 1998, each paid for by the state. But when Puente turned 21 last June, she aged out of her state-funded health insurance and was unable to continue treatment at UCLA. This year, her liver began failing again and she was hospitalized at County-USC Medical Center.

This is the story of a dog-ophobe, a dog-ophile and the parasite that brought them together. The dog-ophobe (for want of a better word) is a patient. The dog-ophile is her doctor -- me. My story is simple. At the end of the day, I look forward to two spaniels at home more than I do comfort food. Their wags are my Prozac, their snores my lullaby. So now you know where they sleep. Not under the bedcovers, but close. By coincidence, my work also involves animals, but with a twist.

A Friday funeral was set for the Northridge teenager who died last week after her insurer refused to pay for a liver transplant and then reconsidered. Meanwhile, the girl's health plan stood by its initial decision Monday.

The case of a Northridge teenager taken off life support just as her insurance company reversed itself and agreed to pay for a liver transplant is highlighting tensions among physicians, patients and insurers over the definition of experimental procedures. Nataline Sarkisyan's family blames their insurance company, Cigna HealthCare, for the teenager's death Thursday.

Dr. Rudi Schmid, an expert in diseases of the liver, a former dean of medicine at UC San Francisco and a key player in bringing about a nationwide system of liver transplantation, died in his sleep Oct. 20 at his home in Kentfield, Calif. He was 85 and had been suffering from pulmonary failure. The first U.S. liver transplant was performed in 1963 and the first successful one four years later.

Doctors in Miami halted liver transplant surgery on the leader of Greece's Orthodox Church because his cancer appeared to have spread into his abdomen. Archbishop Christodoulos, 68, was diagnosed with liver and colon cancer in June after undergoing intestinal surgery, but it was not known that it had spread. Doctors said a transplant was not possible because anti-rejection drugs would fuel the cancer tumors' growth.

His liver rapidly failing, William McMurrough was running out of options. He'd been removed from the waiting list for a transplant at UCLA Medical Center for using marijuana and skipping rehab. The 50-year-old truck dispatcher was critically ill -- with a bacterial infection and other ailments -- when he landed at USC University Hospital. He thought it was his salvation. Surgeons there were undeterred by his deteriorating health and recent drug use.

A Los Angeles woman stranded in Lebanon pleaded with American authorities for days to evacuate her family because her son was running out of medication vital to his transplanted liver. Late Tuesday, she got her wish. Rima Issa and her two young children were to be transferred today to Cyprus, her husband, Amer Issa, said from Los Angeles, where the family lives.

In the world of organ transplantation, location is everything. After waiting more than a decade for a liver, Jonathan Van Vlack was deteriorating. His gut swelled with fluid, and toxins accumulating in his blood made him forget his own name. Still, he wasn't sick enough -- not in New York, where about 2,000 people statewide were vying for the same scarce livers. "He's having a very difficult time right now," his wife, Laura, nervously e-mailed a friend in March 2005.

St. Vincent Medical Center is caught in a new round of troubles, acknowledging this week that it faces a federal investigation related to its now-closed liver transplant program and that it has given pink slips to nearly 100 employees -- about 8% of its staff. The hospital said in a statement that it is "fully complying" with a subpoena received earlier this year from the U.S. attorney's office, which is looking into possible criminal activity in the liver program.