Good news for Sweetness
Patients with liver disease respond well to transplant
Posted: Tuesday February 02, 1999 07:37 PM
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Walter Payton talked about his condition at an emotional press conference AP |
CHICAGO (AP) -- The disease that afflicts Walter Payton -- primary
sclerosing cholangitis -- is an autoimmune disorder, which means the body's
immune system mistakenly attacks its own tissues, in this case, the liver.
The disease scars the bile ducts, which carry bile from the liver to the
small intestine to help digest food. When the ducts get blocked, bile backs
up and migrates elsewhere, to the skin and eyes, causing itching and the
yellowing known as jaundice.
Patients also get fatigued and tend to lose a lot of weight because the
liver stores energy for the body, and when it is damaged or fails, the
tissues starve. Blocked bile ducts may become infected or even cancerous.
The cause of primary sclerosing cholangitis is not known. However, it is
not related to alcohol, steroids, hepatitis or any kind of immunodeficiency
disease.
Dr. Joseph Lagatutta, Payton's physician, said the disease is rare,
affecting about three in 100,000 people, and is difficult to diagnose.
Payton already has undergone a common procedure to treat the disease --
surgical insertion of a stent, or a strawlike tube made of plastic or
stainless steel, to open a blocked duct.
The disease eventually requires a liver transplant, but patients may go
for years before that is necessary, and they usually do well afterward,
experts say. PSC accounts for about 10 percent of liver transplants.
Two Chicago-area specialists said Payton will have to wait his turn for a
transplant, like anyone else.
Dr. John J. Brems, director of intrabdominal transplantation at Loyola
University Medical Center, said he believes it would be "impossible" for
Payton to get a liver transplant faster because of his celebrity.
And Dr. J. Richard Thistlethwaite, chief of transplant surgery at the
University of Chicago, agreed.
"I do not believe he'll get preferential treatment," Thistlethwaite said.
"I think we all know what Walter Payton stands for, and I think he would
probably not want to get preferential treatment."
If Payton gets on a transplant waiting list, he will be given a priority
status by objective measures of liver disease, both doctors said. People
who are the sickest have the highest priority. Within each priority group,
the decision on who gets a transplant depends on factors such as whether
blood types match and how long the patient has waited.
If Payton chooses the Mayo Clinic, he would benefit from its leadership
in research and treatment of PSC and from its location in Minnesota,
Thistlethwaite said.
Mayo is one of only two liver-transplant centers in Minnesota, so fewer
patients are wait-listed there. The Chicago area, by contrast, has five
liver-transplant centers, so waiting times tend to be much longer here,
experts say.
Corlis Phillips, a 34-year-old Loyola patient who has had PSC for 10
years, said it hasn't stopped her from living a full life.
Phillips works full time as a quality-assurance administrator at a
medical consulting firm and also goes to school at night. She is taking
undergraduate classes in preparation for law school. She has been
wait-listed for a liver transplant for four years.
"I live life to the fullest," Phillips said Tuesday. "I stay positive."
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