Carol Trammell jokes she saw her new liver for the first time more than 16 years ago. The 64-year-old Monroe woman was at a bible study group she started shortly after moving to the city, and saw her fated longtime friend get up and walk across the room.
Kim Burke, 52, was tall, and had an observable presence, Trammell said. She was almost luminous. Burke half-facetiously attributes the impression of an aura to a vivid head of red hair. About one year later Burke walked into Countryside Sewing and Vacuum, which Trammell owns with her husband, Lonnie Trammell.
Burke said the two first coalesced while she was “drooling over new machines and wishing.” Over the years their faith and affinity for shared creative ventures, such as sewing, kept bringing them together.
Trammell was diagnosed with autoimmune hepatitis around 1999, almost one decade after her doctor’s found out during a routine procedure that her liver had some unexplained damage. At the time, they said the “chronic persistent hepatitis” — a classification no longer used in the medical world — would never reach cirrhosis.
“With autoimmune hepatitis you are rejecting your own liver,” Trammell said.
She was put on steroids and immunosuppressants. When those stopped working she started having major liver complications.
“The liver is very quiet for a while, and everything starts exploding — there’s lots of symptoms,” she said.
Throughout the years, Trammell has been hospitalized, had various procedures and subsequent complications. In 2011, her white blood count was so low she was nearly quarantined. She was finally listed as a transplant candidate almost five years ago.
An applicant’s priority is determined by their Model End Stage Liver Disease score, which measures how blood clots, kidney function, and the yellow substance found in bile, according to the Stanford Medical Center. Trammell was told she was “sicker than your MELD score,” by her doctor at Swedish Medical Center’s Organ Transplant Center in Seattle.
Trammell spends much of her time alone in bed, affected by fatigue, a minimal appetite and muscle wasting. She said she is likely to “never get a cadaver,” because her MELD score has hovered around 15 on the scale. Most transplants were going through for people who were gravely ill and had above a score of 30 on the scale.
“There are so many people on the waiting list. There is not enough liver donors to keep up with (them), however, many people need the livers,” Trammell said. “So, many people are dying waiting.”
In August 2016 she was assigned a new doctor, who suggested Trammell look into finding a live donor. A family member was tested, but the option fell through. Trammell talked to Burke this winter about the setback, and her friend of more than 15 years repeated a prior offer to donate.
“She said, ‘I can’t ask you to do that.’ I said, ‘That’s fine, you aren’t asking,’” Burke said.
Burke filled out an online questionnaire and was immediately turned down. She was told her history of diabetes, aches and pains, and other issues made her ineligible. Burke sent an email response, stating it was gestational diabetes, which has not arisen since the end of her last pregnancy. She argued that aches and pains “rules out the majority of consenting adults.”
The decision was reversed and Burke went to San Francisco for a workup in February, which included a short psychiatric analysis, blood work and toxicology testing, among many other evaluations. Eventually she was cleared for the donation.
“She’s selfless, she’s just so steadfast and strong in her belief, in her sense of family and friends,” Trammell said.
Getting down to the UCSF Medical Center in San Francisco will be costly. The two-bedroom apartment they will stay in and fill with family members will be just under $8,000 — just for rent. That doesn’t cover travel or living expenses. They may have to stay longer in the flat, depending on how the surgeries go, Trammell said.
Their close friend and neighbor Dianne Forth started a GoFundMe page, which has raised nearly $13,500 in gifts from community members so far.
Once Trammell is well enough that she doesn’t need to be right by the hospital, she will stay in California for another three to four months with another longtime friend, Wendy Younis, until the hospital allows her to go home.
Trammell’s entire liver will be removed, and replaced with Burke’s right lobe. Both lobes will then regenerate; the liver is the only organ in the body able to do so. The majority of the growth will take place within the first two weeks, and the rest slowly throughout the next year, Burke said.
The surgery, scheduled for Friday, April 14, will include cutting through layers of skin, muscle and tissue. Burke will spend up to a week, and Trammell up to two weeks in the hospital afterward for observation. There is the chance that either could die on the table, or from unpredicted but possible complications. There is the chance that Trammell’s body could reject Burke’s liver. Burke said of course the prospect of pain and death is alarming.
Neither woman makes those realities the focus. Both say they are relying on their faith.
“He will take me when it’s time, whether its crossing the street to get my mail, or on the operating table,” Burke said. “We were praying that god would either pave the way or slam the door shut, and everything keeps opening.”
There is also the chance that Trammell will get her energy back. She could regain her muscle and appetite. That is where the two friends say they are fixated.
“I can’t wait to see her healthy and really living, and active in her family’s lives,” Burke said.
A sewing fundraiser for the transplant will take from 10 a.m. to 5 p.m. Sunday, April 23, at Ben Franklin Crafts and Frame Shop in Monroe. A multi-vendor LulaRoe fundraiser will take place noon to 7 p.m. Friday, April 28, at the First Baptist Church in Monroe, and online April 28-30.