Gift of a Lifetime

Professor Nigel Edwards knows that he is a fortunate man. Sitting in the sun-drenched dining room of his Tudor-style home, the pale, wispy-haired University of Toronto geophysicist reluctantly discusses his medical odyssey that literally began with a stroke of luck.

In April 2003, Edwards suffered a mini-stroke. Although unsettling, he quickly recovered and thought that the crisis had passed. But a blood test taken at the time led doctors to discover that Edwards had a degenerative genetic disorder called AAT Deficiency.

AAT is a protein produced mostly in the liver that shields the body’s vital organs from disease. Edwards’ liver was hoarding the protein, instead of secreting it. As a result, his liver had been slowly destroying itself for decades. But apart from an occasional bout of fatigue, he felt fine.

The prognosis, however, was dire. By 2005, doctors at the University Health Network told Edwards that the cirrhosis eating away at his liver was so advanced that he had just a few years to live. His only chance, they said, was a risky liver transplant. Edwards, who is now 65, greeted the ominous news with a mixture of scientific stoicism and alarm. “It was a cross between: ‘That’s interesting’ and…sheer panic.”

Edwards’ wife, Patricia, says that fear reverberated through the family. Their worry was compounded by the fact that finding a suitable donor who matched his O blood type was going to be difficult. Only one of his four children, Kathryn, then 22, had the same blood type. Without Edwards’ knowledge, she volunteered to be tested. She secretly endured a gruelling screening process – which included a battery of psychological and physical tests – only to be told at the last moment that she wasn’t a match. Kathryn’s liver, it turned out, was too small to be harvested.

The family was devastated. As time ran low, waiting for a liver from a cadaver became a dwindling option since locating a match was a long shot. Given his age, Edwards was also low on the transplant waiting list. “The clock was ticking,” he says.

Doctors encouraged Edwards to broaden his search for a living donor. Reserved by nature, he was hesitant. So Patricia quietly put out the word among friends and former students that her husband needed help.

One of Edwards’ previous graduate students stepped forward, but was quickly disqualified because she didn’t share Edwards’ blood type. In early January 2008, Graeme Cairns – who earned a master’s degree and a doctorate in geophysics under Edwards’ supervision during the 1990s – visited Nigel and Patricia. Cairns, a geophysicist working in Houston, was particularly close to the Edwards family. Their sprawling Toronto house had become a second home to him during his postgraduate studies. He knew that Edwards was sick and was seeking a donor, but his Christmastime visit was still a shock. Edwards’ health was deteriorating and Cairns told Patricia that he would consider donating part of his liver.

In April 2008, Cairns called Edwards to invite him to co-write a conference talk. But his former supervisor politely declined the offer, saying he was too ill to work and that doctors had told him that he had only months to live without a transplant. “I decided that it was time to commit,” writes Cairns via e-mail from a research vessel off the coast of Senegal.

And what a commitment it was. First, Cairns had to be thoroughly tested to determine if he was a match. He was. Then he had to overcome fears that the major surgery could go fatally wrong. He also had concerns about the possible lasting impact to his own health. Indeed, Cairns faced a long and disturbing list of potential complications: blood clots, infection, stroke and even failure of the remaining portion of his liver. “I kept turning the decision over in my head…but in the final analysis it was unacceptable to me to stand by and do nothing,” Cairns writes. “Someone desperately needed help and I was in a position to give it.”

In fact, what Cairns gave up during a six-hour operation on June 30, 2008, was two-thirds of his liver. Technically, the operation was a success. But for both men the weeks that followed the surgery were filled with discomfort and doubt.

Edwards spent several days in the intensive-care unit as powerful anti-rejection drugs worked to ward off infections that could abort the donated liver or worse. Morphine helped blunt the post-operative pain. The drugs did their job. After several more weeks in hospital, Edwards and his new and healthy liver were ready to return home.

Beyond the pain, nausea and soreness, Cairns also escaped the surgery’s potentially lethal complications. He returned to his adopted Toronto home where Patricia took care of him as well. By early August, Cairns was back at work and his liver had fully regenerated by later that summer.

Before Cairns left Toronto, the pair teased each other about the size of their boomerang-shaped scars. Then Edwards thanked his former student for saving his life. “I told him,” he says, “[that] I was awfully glad he did this and I was awfully glad that we were both well.”

For Cairns, that simple, heartfelt expression of thanks was enough. “I hope that Nigel will enjoy the extra years he’s gained and will make good use of them.”

Edwards certainly intends to. He has returned to class to do what he loves: teaching a new batch of third- and fourth-year physics students, this time with part of a former student’s liver inside him. “I am a very lucky man,” Edwards says. healthy liver were ready to return home.

For more information about organ donation, please visit www.torontotransplant.org and www.giftoflife.on.ca.