Transplants are demanding procedures for the human body. That’s why certain criteria are in place to give patients the best possible chance for optimal outcomes. Your body must be at a certain threshold of health before care teams will perform a transplant procedure.

Will Fleming, of Wilmette, Illinois, had already undergone two liver transplants: The first liver failed after a year, while the second one went so smoothly that he was able to return to his hobby of cycling, even going 40 to 50 miles at a time.

It was after a 50-mile cycling ride in 2021, at age 68, that Will started feeling sick. He went to the hospital where tests revealed blood clots in the artery that supplied blood to the liver. As a result, he would need a third liver transplant.

“I was in the best shape of my life when they said I needed another transplant, so it was really hard to believe when they told me,” recalls Will. “I was cycling, lifting weights and doing calisthenics regularly. I’d been so healthy for so long; it took a while to realize I was actually sick again.”

A Turning Point for the Possibility of a Transplant

While waiting on the liver transplant list, Will’s health continued to decline. His kidneys failed. He began dialysis. Then, he was told he’d also need a kidney transplant at the same time as the liver transplant.

Will had become too weak to survive a liver-kidney transplant surgery. “We’d discussed it as a transplant team and knew the risks were too high for Will,” explains Transplant Hepatologist Josh Levitsky, MD.

“When he became too sick for transplant surgery, a number of his physicians began suggesting different options,” says Mary Wright, Will’s partner. “They didn’t use the word hospice, but I knew they were talking about just keeping him comfortable.”

That was the turning point for Will. He committed to eating a little more each day. As he gained weight, he gained energy, which he used for light workouts to regain his strength. He put on 15 pounds and went to see Dr. Levitsky for a follow-up appointment.

“He came into my office, and it was obvious he’d been working hard to get healthier,” Dr. Levitsky remembers. “I’d set parameters for nutrition, weight, physical function and frailty. Over three or four months he was able to get there.”

Getting Back to Biking

After that appointment, Dr. Levitsky worked to get Will back on the transplant waiting list. Mary says that he approached every surgeon on the team, addressing their concerns about the risks until they all agreed to perform the procedure.

“Our transplant team has very high standards, and there was still a lot of nervousness about Will, but we decided to go ahead,” Dr. Levitsky explains. A week after Will was re-listed for a liver-kidney transplant, staff at Northwestern Memorial Hospital called him in for the 14-hour surgery.

Though his recovery took longer than he had expected, Will regained enough strength to ride a stationary bike, eventually working up to return to what he loved — cycling outside.

This article was originally published in the Northwestern Medicine Newsroom Press Releases on December 4, 2023.