Transplant Provides Brewster Family with Gift of Life

Arthur Aglieco and his wife Rose never really took life for granted, but they appreciates it so much more now that he has been given a second chance at it.

Aglieco, a 59-year-old Brewster resident, received a liver transplant in October at Mt. Sinai Medical Center, after being told that he would eventually need one 37 years earlier when he was diagnosed with what was then referred to as chronic active hepatitis, which has no known cause.

“Eventually my disease was renamed autoimmune hepatitis. It is in the same vein as HIV, a lot of thyroid diseases,” explained Aglieco. “Basically the body, instead of going after foreign objects like it would the flu; it is attacking your own body.”

Every year Aglieco would go to the doctor and his internist who was also his gastroenterologist would joke that they were able to keep him alive for another year.

“I have been on basically the same regiment of medicine for longer than I have been with Rose,” said Aglieco who will be celebrating his 25 wedding anniversary on Jan. 31, 2013 with his wife. “Nobody would be the wiser for the most part, I just didn’t drink.”

Then about two and a half years ago everything changed.

“All of a sudden my chemistries started to get a little wacky,” said Aglieco. “I went to the doctor and he told me it was time to start looking into getting a liver transplant.”

Getting a liver transplant is not an easy task. “You really do not want to use a live donor,” said Aglieco. “The procedure is just as straining on the donor as it is the recipient.”

So that meant that Aglieco had to be accepted into a transplant program.

Aglieco went down to Mt. Sinai in Manhattan. There he and Rose had to meet with over a half-dozen people, including a social worker.

“The social worker makes sure that you are not only mentally and emotionally ready for a transplant, but that you have a good support mechanism,” said Aglieco. “If you do not have a good support mechanism they will not give you a transplant because you need somebody to support you pre-transplant and post-transplant. Rose didn’t miss any appointment I have had since this process started. I could not wish for a better caregiver.”

In addition to meeting the clinicians, blood work needed to be done. Using the blood work and an algorithm is done that generates a MELD (model end-staged liver disease) score.

“This formula is what they use to determine at what point you are a candidate for a transplant,” explained Aglieco. “The scale goes from six to 40, with six being the lowest and 40 being almost dead or dying.”

Once everything is compiled a board, made up of 40 people who are briefed about the case, determines whether a person is eligible for a transplant.

“The first time I did it, my MELD score was an 11,” said Aglieco.

Transplants are not done on patients until their MELD score is over 15 because it is believed that a person has less risk with their existing liver than they would with a transplanted liver.

From that point on Aglieco went for a visit at Mt. Sinai every three months and although his MELD score was increasing it was still too low for a New York hospital to consider doing a transplant.

The country is broken up in to different transplant regions and New York is a region on to itself.  Other regions consider doing transplants with MELD scores in the 20s, but New York hospitals wait until you are in the low 30s.

The reason New York waits so long is because it has a shortage of donors.

“NY is one of the worst states for organ transplants in the county,” said Aglieco.  “Only 19 percent of the residents are organ donors as compared to 42percent of residents, which is the national average.

So knowing he had a wait ahead of him at Mt. Sinai, Aglieco applied to be listed in another region—Cleveland.

“With Cleveland, what you would have had to do was roll the dice,” said Aglieco. “They could have a match for you when your MELD score was 21, but then you are not out there. “

Cleveland Hospital gives its patients a choice. “As you get sicker you had the option to move out there or they had a program when they would send a jet for you and they would come pick you up,” said Aglieco. “We opted for the jet.”

The process took time; frustration and stress started to mount.

“The frustration is from not knowing whether you are going to get a transplant; you either do or you don’t,” said Rose Aglieco.  “There is no mechanism or mechanical liver to go in and solve the problem, there is no other medication that can go in there and solve the problem. So it the endless wait and the fear that the person is not going to make it. There is also the fact that you watch the person or you are the person get sicker; not being able to work, feeling weaker. The symptoms are getting worse and there is so much medication can do.”

The Agliecos found strength in the Transplant Support Organization. “They have really been our biggest support,” said Rose. “The first people we met when we walked into the room were liver recipients. So it was like really meant to be.”

From TSO the Agliecos learned that there was life after the transplant and the members taught them how to deal with the situation they were in.

Then in October the Agliecos traveled to Cleveland for the final approval appointment to be placed on the transplant list out there.

Aglieco was sick, his MELD score was up to a 31, but he opted to go back to New York rather than stay overnight in the Cleveland Hospital. On the way home from their Cleveland trip Aglieco saw a shooting star.

“I saw it and just said, ‘Hey give me a liver,’” he recalled.

That night they got the call from Mt. Sinai, they had a liver for him. Eight hours later, on Oct. 11 he was on the operating table receiving his new liver.

After the past two years, this holiday season is very special for the Agliecos.

“We are feeling blessed; very lucky and fortunate,” said Rose Aglieco.  “He has a new birthday. It was a rebirth and he was given a second chance at life, literally. You really look at life differently. We learned to put things in perspective. You truly learn to not sweat the small stuff.”

“You have got to be so appreciative to the gift that the donor and donor family has provided you,” said Arthur Aglieco.