Mount Sinai Patient Receives a Life-Saving Liver Transplant Just in Time

Since 2010, Sharon Speer, a working actor from Forest Hills, New York, had been experiencing a powerful itching sensation all over her body. By 2013, topical treatments given to her by a dermatologist had done nothing to alleviate the condition. She mentioned her symptoms to her gastroenterologist, who reviewed her bloodwork and gave her a surprise diagnosis: he suspected the itching was a symptom of primary biliary cholangitis (PBC), an autoimmune disease that slowly destroys the bile ducts in the liver.

The diagnosis was confirmed by a biopsy, and she was then referred to the liver disease team at The Mount Sinai Hospital. This would prove to be just the start of her medical journey at Mount Sinai. She eventually received a life-saving liver transplant carried out by specialists at the Recanati/Miller Transplantation Institute (RMTI) at Mount Sinai in 2022.

Beginning in January 2014, Sharon’s overall care was overseen by Ritu Agarwal, MD, Associate Professor of Medicine (Liver Diseases) at the Icahn School of Medicine at Mount Sinai. Initially, Sharon was prescribed the drug ursodiol, which effectively stopped the itching. For almost seven years, with the exception of a series of fainting episodes, her condition remained relatively symptom free.

However, by the summer of 2021, her condition had seriously deteriorated; her abdomen had grown extremely large, while the rest of her body became emaciated and weak. In August 2021, her care was transitioned to Joseph Odin, MD, PhD, Professor of Medicine at Icahn Mount Sinai and the Recanati/Miller Transplantation Institute. Dr. Odin informed her that her liver disease had progressed to end-stage. Sharon needed to receive a liver transplant urgently, or there was a possibility she could die.

“Even though my stomach looked like I was nine months pregnant, and I knew logically I was seriously ill, I still didn't want to believe it or accept it,” Sharon says. “Dr. Odin gently made it clear that if I didn’t get a liver soon, I may not make it.”

The key assessment of one’s ability to get a deceased donor liver is based upon the model for end-stage liver disease (MELD) score. This is a disease severity scoring system for patients with liver disease that is based on several lab test results. Out of a potential score of up to 40, Sharon’s score was 14. Although significant, it was not high enough to guarantee her as a priority for a deceased donor, since in the United States there are so many more people awaiting a liver than there are available donor organs.

In October 2021, Dr. Odin referred Sharon to Sander S. Florman, MD, Director of the Recanati/Miller Transplantation Institute, and a renowned specialist in liver transplant surgery.

“It is very hard for patients like Ms. Speer, who are clearly sick enough to need a liver transplant but because there are not enough available organs, they have to wait and get sicker and sicker,” Dr. Florman says. “Some are fortunate enough to identify a living donor who can give them part of their liver. We have learned over the years how to successfully utilize livers from donors with many comorbidities or other problems, and this has allowed us to get patients like Ms. Speer transplanted in a more timely fashion.”

Dr. Odin suggested that she look into finding a living donor. Living donation involves a healthy person donating a part of their liver. The liver is able to regenerate, growing back after part of it is removed and transplanted. Sharon’s brother offered to be assessed as a live donor, but unfortunately, tests showed him to be incompatible.

“My brother Jamie, who I love dearly, said, “I'll do anything to help,” Sharon says. “He went through all the tests, and it's a big process. Zoom calls, psychological questions. But when they tested his liver, even though it was healthy, it wasn’t a good match. ”

Despite reservations about letting people know about her condition, Sharon felt that at this point she had to widen her search for a live donor. “I felt I just had to, because I didn't have a choice,” Sharon says. Over the next few months, her search for another donor was unsuccessful.

One day in October 2021, Sharon started to feel unwell and developed abdominal pain that was severe enough for her to call an ambulance to take her to the local emergency room. After a week of tests, Sharon then transferred to Mount Sinai where she underwent a paracentesis, a procedure to remove fluid from the abdomen. This led to a diagnosis of spontaneous bacterial peritonitis - an infection of fluid accumulated in the abdomen that is often associated with end-stage liver disease. Sharon spent more than two weeks at the hospital in recovery.

The development of peritonitis indicated that Sharon’s condition was worsening. Combined with her blood test results and her increased MELD score, Sharon now had a much greater chance of receiving a deceased donor if one became available in time. In January 2022, she received the call from Mount Sinai that was to save her life.

“I answered the phone, and I heard, ‘Miss Speer, can you get to Mount Sinai in 45 minutes? Because we might have a liver for you,” Sharon recalls. “It was Marren Sunga, my liver transplant coordinator. So I took a two-minute shower, brought my toothbrush, my phone charger and a journal and called an Uber.”

Sharon received a liver from a 45-year-old deceased donor. Dr. Florman successfully performed her liver transplantation that night, with an additional procedure to finalize connecting the bile ducts a few days later.

“Ms. Speer has a remarkable will to live—a real joie de vivre—and she is a fighter. Despite her chronic illness and the significant challenges she had while waiting for a liver to become available, she always had a terrific attitude and believed that she would get a liver and get better. Could not be happier for her. Transplant has restored her life. It is remarkable.”

Overall, Sharon spent over a month in the hospital because she was so ill before the transplant. Family and friends were regular visitors during that time, and she received an abundance of well-wishing cards.

“When my family had asked me what I wanted, I said greeting cards,” Sharon says. ”And I got over a hundred cards. The hospital said they had never seen this many for one person. And all my friends came to visit, and my family was there. I had so much support.”

When Sharon returned home, recovery from her transplant surgery would take time. “When you get a liver transplant, you’re going to be on a rollercoaster,” Sharon says. “You're good, then you're bad. It really is true when they say it takes time to be fully recovered, to feel back to being yourself.”

Over the next nine months, her incisions healed, and her abdomen went down to a normal size. She gained weight and strength and underwent physical therapy.

“They make you feel like you are part of a team,” Sharon says. “You have your surgeon, your main doctor, your coordinator, you have a dietician, and a social worker. They all work together as a team.”

By the time of her one-year anniversary appointment in January 2023 with Dr. Odin, she was given clear marks: her liver numbers were better than ever, and she had no signs of rejection of the transplant. After a follow-up in July 2023, she received further good news: her next appointment with Dr. Odin will not be until the following year.

“I've never felt healthier,” Sharon says. “And all I want to do is share my story and inspire people to believe that we can do hard things. I want to thank everyone: my donor, her family, my friends, my family and everyone at Mount Sinai who took care of me – the nurses, the chaplain, all of the support staff, and of course my doctors — without them, I wouldn't be here.”