Veteran liver transplant recipient remains sober and symptom-free

After his liver transplant, a Veteran turned his life around.

Allan Howell (pictured above) was admitted to Central Arkansas VA in fall 2020 with deep jaundice and abdominal distention. He was diagnosed with severe alcohol associated hepatitis and test results on his liver produced elevated readings. His liver disease was not responding to medical treatment and his kidneys started shutting down.

The only treatment option left to consider was orthotopic liver transplantation. A transplant evaluation was completed immediately and Howell was transferred via medical flight to Houston VA, the nearest VA transplant center.

At Houston VA, he was estimated to have 30 days to live. He was placed number one on his regional transplant list and within eight days had a donor. Howell underwent a successful liver transplantation in November 2020.

Near-death experience has led Howell to live his best life ever

“I took that near-death experience to heart,” he said. “I was released after my surgery on Dec. 4. On Jan. 6, I got a gym membership. I didn’t even have a car yet. I was walking every day to the gym. I consistently enroll in fitness classes and competitions such as Orange Theory, F45, and High Rocks.”

Howell is the first person from Arkansas to undergo a successful liver transplant for acute severe alcohol associated hepatitis. He continues to remain sober and symptom-free. Central Arkansas VA’s liver team spearheaded this process.

“Howell’s dedication is evident in his transformation,” said Liver Specialist Dr. Ragesh Thandassery. “We are proud of Mr. Howell’s dedication following liver transplantation. He has been sober and living an exceptionally healthy life. We love sharing his success story so that we may raise public awareness regarding the dangers of excessive alcohol consumption.”

VA doctor, health care team, set him on journey to new life

Howell looks back on the series of events that landed him in Houston and credits his health care team with laying the groundwork for his journey to a new life.

“Dr. Thandassery helped me start this journey. He advocated for me to get the help that I needed and pushed for me to get transferred to Houston,” Howell said.

Howell began his journey at 247 pounds, and today he is 190 pounds and competing in grueling competitions that require exceptional physical and mental endurance. He serves as a role model for Veterans who may find themselves in a similar position.

Complications from alcohol use disorder

Alcohol use disorder (AUD) is extremely prevalent in the United States. Alcohol use can result in numerous liver diseases. In early stages, AUD can cause fatty liver disease. Excessive drinking can sometimes cause alcohol associated hepatitis, which often leads to a dramatic rise in liver numbers and patients becoming very sick.

Long term alcohol use can lead to cirrhosis, resulting in end-stage liver disease. It can also cause liver cancer. The most important step in management of these conditions is to end alcohol intake. Although, sometimes quitting alcohol alone cannot reverse the disease’s course.

Traditionally, liver transplantation is only considered in patients with AUD after six-months of sobriety. This is an attempt to ensure that they remain sober after transplantation. Patients with severe alcohol associated hepatitis have high mortality rates and very few tend to survive the six-month period.

The waiting list for liver transplants is long and the sickest on the list typically are the first to receive a liver.

Follow ups with addiction specialists are required

There is debate on appropriateness of using limited donor organs for candidates with AUD. Recent studies have shown relatively low levels of alcohol relapse after early transplantation in carefully selected patients.  However, the selection process is complex and usually follows multidisciplinary team discussion. The criterion for selection is still being revised and refined.

After patients receive their transplant, close observation and follow ups with addiction specialists are required.

Central Arkansas Veterans Healthcare System strongly recommends against excess alcohol use. If you come across a Veteran with severe alcohol associated hepatitis, please refer them to their local VA medical center or their VA health care team.

Veterans could be candidates for early liver transplantation, and they deserve expert evaluation. VA transplant centers are among the few centers in the U.S. that perform transplants in patients with severe alcohol associated hepatitis with excellent results.

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To learn more about liver health, visit VA News and Information.