Alex Beltran closed out 2020 with a new lease on life.
The 36-year-old Reading man was the recipient in Tower Health Transplant Institute’s first liver transplant at Reading Hospital on Dec. 3.
“There’s no doubt in my mind that if it wouldn’t have been for this team, I wouldn’t be here today with my kids and my wife,” Beltran said a little more than a month into recovery. “Everybody from the nurses to the doctors, everybody cared about my condition. I’m really grateful for them.”
Beltran, who suffered from Wilson’s liver disease, experienced a range of serious health complications due to his condition last year.
His liver functions quickly declined in the last weeks of November. According to his team of doctors, patients with such severely weakened livers suffer near universal mortality without an immediate transplant.
“My wife, she’s just beyond being grateful to God, the doctors, everybody that helped with my situation,” Beltran said. “When I got home, she told me that I was her gift for Christmas.”
Care closer to home
The first liver transplant being performed at the institute is not just good news for Beltran and his family, but for the whole community as well, according to Reading Hospital-based Tower Health.
“It’s important for the patients with end stage liver disease in Berks County and the surrounding areas,” said Dr. David J. Reich, institute director. “There is a large abundance of liver disease in the community, and patients had to travel far to get expert liver care. That’s no longer necessary because we’re able to provide that safely and in a patient-focused manner at Reading Hospital.”
Reich added that the transplant institute team has more than 10 physicians and about 40 transplant team members across different specialties. Beltran’s surgery was performed by Reich, Dr. Gary S. Xiao and Dr. Stephen R. Guy.
“Now in Reading there is a team of four hepatologists that can focus on it (the treatment of liver disease),” said Dr. Santiago J. Munoz, Tower Health Transplant Institute medical director of liver transplant and the center for liver disease. “Now we have a team here of specialists and hepatologists that can cure diseases like hepatitis C and manage complicated liver diseases and even very rare liver conditions as Alex has.”
The Tower Health Transplant Institute team was formerly at Hahnemann University Hospital in Philadelphia and joined the Tower Health team in late 2019.
Munoz and his hepatology colleagues Dr. Vishal Patel, Dr. Andres R. Riera and Dr. Eyob L. Feyssa made it possible for Beltran to survive until a new liver was available as he experienced numerous medical challenges.
“As his liver began to deteriorate last year, we had to embark on the treatment and management of his liver failure, which at the end required micromanaging every aspect and every complication of liver failure up to the time he got an organ,” Munoz said.
“He’s such a strong man that he overcame each one of them with a little bit of help from us and God of course,” Munoz said. “Alex was an incredibly resilient and determined young man. We almost knew from the beginning that he was going to make it through the liver failure to the surgery.”
Beltran was diagnosed with Wilson’s liver disease when he was 21 years old. It is a rare inherited genetic disease that causes dangerous levels of copper to accumulate in the liver, brain and other organs.
Munoz met Beltran about 11 or 12 years go, shortly after Beltran was diagnosed.
Over the years, Munoz has helped Beltran take care of his complicated liver condition. Beltran said that when he started seeing Munoz for his condition, the doctor explained to him that he would need a liver transplant at some point.
“It was kind of hard to deal with the whole idea just from a human point of view,” Beltran said. “It was a challenge for me.”
After living with and managing the condition for years, Beltran began to experience severe complications last year.
“He’d really run the fullest spectrum of complications of liver failure,” Munoz said.
Beltran’s liver functions quickly declined in the last weeks of November, including a bad attack of a blocked gallbladder that needed emergency treatment and contracting COVID-19 outside the hospital that then required hospitalization.
Munoz said it was remarkable to see how Beltran was able to withstand liver failure and on top of that, COVID-19.
Reich described Beltran picking up COVID-19 as being almost the straw that broke the camel’s back.
“His breadth of complications over the past year were quite significant, and I think it speaks to not only his strength, but to the capacity of many specialists, hepatologists and other team members who helped him along the way,” Reich said. “His score was so high that he made it to the top of the (transplant) list as one of the sickest patients in the United States.”
Beltran was listed as status 1A, which is for the most critically ill and high-risk among waitlisted individuals. According to Tower Health, only about 3% of all liver transplants performed in the country are for status 1A candidates.
“An emergent liver transplant was the only option for Alex’s survival,” Munoz said. “Given his worsening condition Alex had priority for the first available liver within a 500-mile radius. He matched with the donor in the nick of time and got his chance.”
Reich noted that the liver donor was nearby and shared a rare arterial blood supply to the liver Beltran had, making this a special match. The transplant could still have been performed had the blood supply not matched.
“We felt it was sort of a match made in heaven if you will,” Reich said. “It’s of interest, almost as if the donor liver was destined for Alex.”
Beltran received the call that a liver was available at 3:39 a.m. while he was in the hospital.
“I immediately called my wife and then my mom,” Beltran said. “They both said, ‘There is a God, and he heard our prayers.'”
Reich was with Beltran outside the operating room and recalled Beltran’s wife and mother each giving him a kiss before going into surgery.
“I won’t forget the confidence on his face,” Reich said. “He told them he wasn’t scared and everything would be fine. That confidence from him was really infectious.”
Beltran remembers being calm as he went into surgery.
“I put my life in Dr. Reich’s hands and the surgeons and the whole team,” he said. “I’m here today because of them. I’m here with my kids and hopefully I’ll get to see them grow and be old. It’s all thanks to this team. I couldn’t be more grateful.”
Beltran remained stable throughout the surgery, and the operation went smoothly. He has had excellent liver function following surgery and is recovering ahead of schedule.
“Organ donation is a special gift and it saved my life,” Beltran said. “I wouldn’t be here today if it hadn’t happened. I think about it a lot that someone passed away, but I am grateful that I get to see my kids grow.”
While most liver transplant patients typically stay in the hospital an average of 12 days, according to Reich, Beltran was able to return home after just one week and is healing well.
“It is incredibly gratifying to see the result of the surgery in somebody that was so close to dying as Alex,” Munoz said. “I’ve been working in transplantation for 37 years, and it’s to me still incredibly wondrous to see how the patients are at the doors of death and then just a few months later they are strong, they have a tremendous level of energy and resume their life with very few limitations.”
Reich hopes Beltran’s story encourages other patients to not delay medical care due to the COVID-19 pandemic. Early detection and treatment lead to better patient outcomes.
“Alex was lucky, he was booked into the system and other patients need to access care,” he said. “Timely visits with health care experts can be lifesaving. Tower Health has COVID-safe pathways to care for transplant candidates and recipients, and all other patients.”
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