The gift

Last in a four-part series

Candida Gutierrez woke from the fog of anaesthesia and glanced down at her hands.

Such a beautiful color, she thought.

That was when she knew she had survived.

Gutierrez, 38, had been dying of liver disease seven hours earlier when attendants in scrub suits wheeled her into one operating room, her husband, Victor, into another.

Now, a piece of Victor's healthy liver was inside her, filtering her blood and giving her strength. Her body radiated with pain, but she felt revived. Her skin no longer was a sickly gray. And Victor? He also was doing just fine, said the family members who circled her bedside, weeping with joy.

Candida Gutierrez silently thanked God. She thanked her medical team at the University of California, San Francisco, Medical Center. She thanked the many members of her church community who helped her cook and clean and take care of her children during the months when she was too weak to do it herself. And she thanked Dan Haverty, the man who inspired her and her husband to take this risky but potentially lifesaving journey.

Just a few months earlier, Haverty, a Sacramento firefighter, had donated a portion of his liver to save a man he hardly knew. That man was Bishop William K. Weigand of the Catholic Diocese of Sacramento. Within days of the operation, the bishop was up and about, flush with newfound health, talking on television and in the newspaper about this miraculous development.

Victor and Candida Gutierrez of Stockton were watching. So was Ross Frazee, a Bay Area man whose lifelong friend and father figure, 58-year-old Dan Gramm, was wasting away from liver disease.

Soon, Haverty and Weigand's "miracle" would lead to two more.

Victor Gutierrez and Ross Frazee were among at least six people who were inspired by the bishop's story to put their own lives at risk to save someone they loved.

Victor Gutierrez had been married to Candida for 16 years, and he adored her as much as the day they met at a bowling ball factory in Los Angeles nearly two decades ago. Frazee, who like Dan Haverty made his living fighting fires, loved Gramm like a father.

So for both men, a medical rescue mission seemed entirely appropriate.

Candida Gutierrez got her new liver in August. Gramm's transplant was last month. In both cases, the operations were successful though complicated for both the donors and the recipients. Gramm has been in the hospital for most of the past six weeks, fighting infections and other problems. He was released Dec. 19 and doctors believe he will recover.

"It's still a little rough," he said. "But I'm getting there."

At least four other healthy people, similarly inspired, contacted UCSF after the bishop's operation in April to offer their own livers to loved ones, but for various reasons including liver incompatibility, the operations never happened.

"For us, thank God, everything worked," Candida Gutierrez said through a Spanish interpreter at her family's home in Stockton, her husband and her parish priest by her side. "It is like being born again."

Frazee, who has known his friend Gramm for more than three decades, had a spiritual awakening and has become an activist for organ donation. He has joined a UCSF support group for liver donors and recipients and even talked a hair stylist into shaving "LVR" into the back of his scalp.

"It's just such an amazing thing," said Frazee, a 41-year-old divorced father of two, as he lifted his Menlo Park Fire Department shirt to reveal an angry semicircle of a scar. "I had the key to saving Danny's life all along. I just didn't know it.

"Danny's hurting right now," he said. "But his liver is working, and mine is coming back. It's a miracle."

Prior to her operation, Candida Gutierrez could not remember a time when she felt completely healthy.

"Since I was a little girl, I had aches in my stomach," she said. "I had a lot of headaches. I was always tired. I got dizzy. I used to get upset and angry and I felt guilty."

As the years passed, Gutierrez got worse. In time, she was so weak she had to give up her job in child care, and she could barely muster enough energy to pick up a broom and sweep the floor, wash the dishes or care for her two children.

Doctors were unable to diagnose her condition until about three years ago, when she ended up in the hospital, shaking and in pain, fluid filling her lungs. Gutierrez was shocked to learn she had cirrhosis of the liver. It was a diagnosis most commonly seen in drug addicts and alcoholics, and she had never been a substance abuser. In about 20 percent of cases, doctors told her, the cause of cirrhosis is unknown.

But the bigger shock came when physicians told Gutierrez that her best hope was a transplant in which surgeons would remove a portion of a compatible donor's liver and give it to her. It would be risky for both people, and it was a long shot.

She had little choice. The list of people waiting for cadaver donors was so long, the doctor said, that it would be almost impossible for her to get one of those organs in time to save her.

"I got a nervous shock," Gutierrez said. "It took me a long time to accept it." She broke the news to her husband and her kids, Victor, 14, and Eliana, 12. "It was understood that I could die," she said, "and I was so afraid of leaving my children."

Within weeks, testing began on Gutierrez's blood relatives, those most likely to be compatible donors. None of them qualified.

Gutierrez did not want her husband to go through the surgery because in the most dire scenario, their children would be left orphans. But he became her last hope.

Victor Gutierrez was more than enthusiastic. He remembered the day he and his wife saw the bishop on television back in April, walking around within a week after his surgery, and how it lifted Candida's spirits. He remembered Dan Haverty's incredible gift to Weigand. He insisted on being tested.

"I had faith that one way or the other I would be able to help her," said Gutierrez, 40, who works as a truck driver. "I started calling UCSF, sometimes two or three times a day. I kept persisting. I almost demanded that I get tested."

After three days of biopsies, blood tests, psychological tests, CT scans and X-rays, doctors determined that Gutierrez was a perfect match. He could save his wife's life, but in order to do so he would risk his own.

Living-donor liver transplants have only been done for about 15 years, and early studies show that close to 90 percent of recipients remain healthy after one year. But healthy donors can end up sick, or even dead. In about 1 percent of cases, complications from liver donation are fatal. In up to 67 percent of cases, donors develop complications, and about 20 percent of complications are serious, from infections to bowel obstructions.

"The doctor said we would be trapeze artists on a rope and that things could go either way," Gutierrez recalled.

He told his wife that he was going to go forward.

"I didn't want him to," Candida Gutierrez said. "I was numb. I didn't know what was right or wrong. But he never asked my opinion."

So the couple checked into UCSF Medical Center. On a Thursday morning in early August, they looked into each other's eyes one final time before going off to surgery.

"I asked him one more time if he was sure about it," Candida Gutierrez said. "Then I gave it over to God and asked him to help us."

The following day, she woke up in the intensive care unit, and saw the faces of friends and relatives. They were crying and smiling at the same time. She flexed her hands.

"They had color in them. Before, they were so pale." She was thrilled, but worried about her husband. Where was he? Was he OK?

He was just down the hallway. She saw him a few hours later, and they laughed through their pain.

The next few weeks would be difficult. Victor would suffer a bowel obstruction while in the hospital and later come down with a serious infection that was treated with antibiotics. Infections would also send Candida back to the hospital.

But today Victor and Candida are healthy, strong and eternally grateful.

On one of their visits to the UCSF clinic, the couple met Bishop Weigand.

"He gave us a blessing," Candida recalled. "It was pretty big for us."

On a recent Sunday, parishioners at St. Edward's Catholic Church welcomed the Gutierrezes back to Mass, where pastor Leo Suarez spoke about the joy of giving and receiving the ultimate gift.

Victor still has some pain, but not enough to justify taking the pills his doctor prescribed, he said. He plans to return to work after the first of the year. Candida laughs easily and has the energy to cook elaborate meals and care for her family. She has never enjoyed housekeeping so much.

"I can mop, I can sweep, I can go outside and take care of my plants," she said, smiling broadly. "I will never be able to repay everyone for helping me. Without my husband, my family, the doctors, my church family, I don't know what I would have done.

"But I want to be able to say thank you," she said. "Right now, I feel like I could live forever."

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The ethics of living-donor transplants

Liver transplants from living donors remain controversial. The Hippocratic oath commands doctors to "do no harm," but physicians place healthy people at risk when they remove as much as two-thirds of their livers and transplant them into sick recipients.

Dr. John Roberts, chief of transplantation surgery at the University of California, San Francisco, said that when the patient is at risk of dying, it makes ethical sense to give healthy loved ones an opportunity to help. "We try to choose donors for whom the risk of complications is relatively low, and do the transplant on people who we think the benefit will be very high," he said.

Still, Roberts said, it would be far better never to put a healthy person at risk and use only livers transplanted from cadavers. "If we had enough of those to go around, we wouldn’t have to use living donors, and that would be a good thing," he said. "The real key to all of this is for people to arrange for their organs to be donated."

– Cynthia Hubert

About this series

The Bee's Cynthia Hubert visited with Bishop William K. Weigand and liver donor Dan Haverty at the University of California, San Francisco, Medical Center after their surgeries. She also spoke at length with Haverty's wife, Terri, and the surgeon who led the transplant team, Dr. John Roberts.

Later, Hubert explored the ripple effects of the story, which received nationwide coverage. She discovered that at least six people had agreed to pursue the risky prospect of donating a portion of their own livers to loved ones after learning about Haverty's gift to the bishop.

She traveled to Foster City to visit with Ross Frazee, who became a donor to his longtime friend Dan Gramm, and to Stockton to interview Victor and Candida Gutierrez. Victor Gutierrez saved his wife's life by becoming her liver donor.

Over the past eight months Bee photographers have documented the many stages of the recovery process of Weigand and Haverty and other liver transplant recipients.

Hector Amezcua photographed and translated for the story on Candida and Victor Gutierrez. Other photographers who contributed to the series were:

Carl Costas

Michael A. Jones

Bryan Patrick

Lezlie Sterling

José Luis Villegas

About the writer:

• The Bee's Cynthia Hubert can be reached at (916)321-1082 or chubert@sacbee.com.