Sunday, November 07, 2004

The greatest gift of all

A liver for a life: Kumudini Hettiarachchi meets the courageous Sri Lankan who donated half his liver to save a man whom he had looked up to as his godfather.

A split-second decision of a young man changed the lives of two forever, binding them for a lifetime. For, now they share a liver. One of them, who himself as a doctor has served thousands of people has got a fresh lease of life, while the other has made the greatest sacrifice a human being can make while alive.

Meet Ishantha Stephen, the person who gave half his liver to his family doctor whom he treats as his "godfather" ever since his own father, Col. H.R. Stephen, died in the same bomb blast that killed Major General Denzil Kobbekaduwa in 1992 in the north.

"I am O Positive Ammi, I will give my liver, I said that Thursday in July," recalls Ishantha, 26. "I did what I had to do and wanted to do," he adds, blushing. He is embarrassed by the media's interest in him and takes a while to unwind.

"I remember the day well because I was at the auction when the call came. It was my mother. She sounded distraught. She had visited doctor uncle's clinic in Kandy, my hometown, and heard that he was very ill. He had liver cancer and needed an urgent transplant." Ishantha works as a Marketing Executive in the rubber division of Forbes and Walker in Colombo.

Not only family physician but also close family friend, Dr. Sarathchandra Kapuwatte is the father figure Ishantha and his younger brother looked up to growing up fatherless since 1992. "He gave us much moral support soon after my father's death, when wild rumours were floating around. I was only 15 and my brother just eight. It was a tumultuous time for us. His whole family stood by us. He had also treated my father for diabetes so there was a close bond."

Early this year, 64-year-old Dr. Kapuwatte was diagnosed with life-threatening liver cancer. In July his condition was deteriorating rapidly. When Sriya, Ishantha's mother went to his clinic that July day for a pressure check, the staff at his clinic told her about the search for a liver and she immediately offered hers. But her blood group was A Positive and not compatible.

Dr. Kapuwatte required half the liver of a person with O Positive blood and Sriya called her son in Colombo asking him to find a donor quickly, not realizing that he himself had the compatible blood group. Ishantha, a regular blood donor, carries the donor card with him.

"Mata bayayi, oya podi," was his mother's reaction when he offered his liver but he consoled her saying, "If I have to die, I will, when my time is up. It is better for me to do something good. Let me grab this chance to save uncle."

She was convinced that no evil would befall him from such a good deed and set about the delicate task of breaking the news to his Malli who is pursuing flying lessons in America and also his fiancée, Niluka Pathirana. Wedding bells were to ring for Ishantha and Niluka in December.

From then things happened quickly. Ishantha met Prof. Arjuna Aluwihare who was Dr. Kapuwatte's surgeon in Kandy, and was told in detail about the transplant. He then underwent initial tests in Sri Lanka.

Being an old Trinitian, he was planning to watch the Bradby the following weekend when the call came that he had to fly to Singapore immediately. Dr. Kapuwatte was already there. The transplantation was to take place at Gleneagles Hospital, a leading private hospital in the region that has a 'Living Donor Liver Transplant Programme'. It was also the first in Singapore to carry out a transplant involving a living non-related donor late last year.

August 4 saw him taking the flight, along with his mother, to face a set of rigorous procedures over in Singapore. Not only had Ishantha to undergo a battery of tests there but also meet a psychiatrist and face an Ethics Committee, which literally "interrogated" him on why he wished to donate half his liver though not even distantly related to Dr. Kapuwatte. "Are you getting any property? Are you getting money? Are you being threatened or under duress?" the committee from the Singaporean health ministry asked him. "Normally, they question you for about one and a half-hours but I got away in 15 minutes," he laughs.

'Operation liver transplant' was set for August 18. As Ishantha worshipped his mother and told Dr. Kapuwatte, "Athule hamba wemu", in Singapore, his fiancée was praying for him in Kandy. He was wheeled in to the theatre at 6.30 in the morning and opened up at 8 a.m. Dr. Kapuwatte was taken in around the same time and the simultaneous operations conducted side by side were underway. Ishantha was back in the ICU after eight hours sans 750 grams (50%) of his liver and Dr. Kapuwatte nearly 11 hours later with the diseased liver out and a brand new half-a-liver in.

Being heavily sedated and hazy, for about four days after the transplant, he didn't feel anything. Thereafter? He prefers to stay mum but the shadow that passes over his face tells all about the excruciating pain. No words are necessary. His only comment is that the cut on his stomach is known as the "Mercedes cut" as it is in the shape of the famous car brand's emblem.

Three days after the operation a surprise awaited him -- his beloved fiancée who had so willingly agreed to put off their wedding for June 2005, was by his side. His mother had arranged for her to come too. "I am so proud of him," Niluka told The Sunday Times on the phone from Kandy yesterday.

Now back at work, Ishantha is gradually returning to his routine. "I don't swim yet, but I do everything else like driving the car," he says. For him there is nothing amazing in a young and healthy person donating part of his liver. He feels it is what any human being should do for another if he can.

"I went in knowing the dangers. That there could be massive haemorrhage or my liver could get infected and I could die. Now my liver has grown back," says Ishantha simply. "I felt I had to do it and it is worth it."

“I'm happy to be alive”
"Ishantha did a noble deed. He is like a Bodhisattva," says liver recipient Dr. Sarathchandra Kapuwatte. "I don't think any liver transplants, either live or from cadavers, have been attempted in Sri Lanka," Dr. Kapuwatte told The Sunday Times when contacted on the phone in Singapore on Thursday.

He was undergoing a check-up there and was due to fly back to Sri Lanka on Friday night. "I am happy to be alive," added Dr. Kapuwatte. Six simple words that mean so much. What greater sacrifice can one make than sharing a liver to give life to another.