A year passed from first transplant from a living donor to a patient with metastasis of colon cancer carried out at the Favaloro Foundation University Hospital. It was a novel medical practice that in our country has no history and is writing its incipient history. A moving, mobilizing and painful story -also- due to the long road traveled by the protagonists, although with a happy ending.
Mother and son are the protagonists of the story. Santiago Beier (28) donated part of his liver to Fabiana (55), who since 2015 had been fighting colon cancer with liver metastases. Two operations, radiotherapy, chemotherapy, but the tumor returned and the last time she did it in an impossible place to carry out a new intervention.
Santiago lives in Buenos Aires, where he works in a cosmetics company and is about to receive a degree in international trade. Fabiana is in Coronel Suárez, and today –after a lifetime of rolling up her sleeves– she is a housewife. “At first it was hard for me to not do too much, especially after my story, but I convinced myself that it was the best thing for my daughter, who is still a girl,” she says.
Although they are the ones who take the credits for this film that combines drama, action and comedy, you cannot ignore Gabriel Gondolesi, one of the heroes, prone to the low profile. Surgeon and head of a multidisciplinary team at the Favaloro Foundation, was in charge of the unprecedented intervention. “It was a great challenge for us as doctors and we took it with the seriousness and humility that surgery of this caliber requires. Also honestly, since we told Fabiana and Santiago that it was also our first time,” he says.
Gondolesi, who has carried out 1,200 transplants (liver, pancreas and intestine), was facing an unknown operation. “And as happens in this type of surgery, results cannot be guaranteed because there are multiple factors that intervene beyond the surgery itself, such as seeing how the immune system and the transplanted organ coexist, or the immune system and the cancer itself. You don’t have a crystal ball”, describes the doctor, whose premise is “to put yourself in the patient’s place, always”.
The significance of this intervention –so far unique in the country– is not that a liver transplant has been performed with a living donor, a practice that has been performed, with adults, since 2001, but rather that it has been performed this operation on a patient with metastatic colon cancer. “What was new was the condition of the patient, whose prognosis for life had no future… So, since it was a first time with a sick patient, the Ethics Committee of the Favaloro Foundation approved that the donor be a living person “.
In this way, Gondolesi slides, he removed the possibility of entering into controversies for using organs of the pool of cadaveric donors in a country like Argentina where the donation is very scarce. “In this case, the innovative technique was applied to a patient whose donor was brought by the recipient himself.”
unbreakable relationship
Mother and son are healthy, leading a life with total normality. “I’m fine, I travel to Buenos Aires once a month to do check-ups and luckily they are reducing my medication. I used to take 20 pills a day, now I’m down to 15. The chemo? a distant memory“, says Fabiana, who sets the alarms on her cell phone for each pill.
Santiago shares: “I had a quick recovery, I do gymnastics, I run, I eat everything and mom look at her… she has another face, another color, she is a happy woman, who enjoys making jokes, who wants to travel.”
He looks back and the young man cannot believe it, who ends a great 2022 personally and professionally. “Last year was something else, full of uncertainty, with my mother’s health in leaps and bounds. Getting to the transplant with this result Obviously, it was the best decision, but it already was when we had a talk with the doctors and there was the possibility of either a long, extremely expensive and uncertain treatment, or a transplant. moment, I didn’t think twice, it came naturally to me”.
Review that sequence in a Favaloro Foundation office back in August 2021. “I was primed, but I was rational at the same time and I told the doctors and my mother. ‘If the transplant is confirmed, I want to be the donor’. I wanted to give my mom a life with a different quality, she had fought a lot and it was a concrete possibility to pay her back for all the sacrifices she made for me. And you don’t know how good it feels to have collaborated so that she is as she is today,” she says.
Fabiana transmits serenity, relief and temperance. She puts in snacks every once in a while, she prefers that it be her son who expresses herself. “I’ve been living a different life for a year, with projections to the future, with projects, that’s priceless, sometimes I can’t believe it. I spent more than six years with the disease… and one gets used to being bad. But now is… As I tell my husband Oscar, My new birthday is December 1st.the day the surgery was performed and in which my life took a turn, I don’t know if it was unexpected, but it was very desired,” he let it be known.
The Beiers are tough nuts to crack, they passed those of Cain and nothing scares them anymore. “My old woman is a Spartan soldier, she raised me as a single mother and worked from Monday to Monday (in a greengrocer and an ice cream parlor) so that I did not lack for anything. She always kept me impeccable, up-to-date and instilled in me to study , something that she could not do. We were always united, buddies, we have an unbreakable relationship, we are a team, how could I not donate my liver to her!”, defines Santiago.
The so-called hinge
In September 2015, Fabiana looked very thin, almost did not eat and vomited the little she ate, but she had no pain. In a couple of months dropped from 62 kilos to 47, but she hardly noticed it. “She thought it was nerves, stress, but she didn’t look like a sick person. My husband didn’t care either.”
In a consultation with the doctor, the clinician was struck by some laboratory values and urgently referred her to the oncologist. After rigorous studies and plaques, he was diagnosed with colon cancer. “I work as a tutor in a school, in Buenos Aires, and a few minutes before I was to enter my mother called me. ‘Santi, listen to me… I have cancer’. It was direct, no twists. I fell to the floor, my knees gave way, I don’t know if I collapsed or what, but after two days I resigned and went to Coronel Suárez to be with her,” he recalls.
Always a fighter, stoic and decisive, Fabiana was annoyed by the arrival of her son, but after hours she felt content to have him by her side. By then, Oscar, her husband, and Lourdes, her daughter, who is 13 years old today, were already in her life. “Luckily my daughter never found out about her, I didn’t give her reasons, she didn’t see me in a complicated situation either, at most some indisposition. But I armed myself so that she would see me as always.”
Santiago reinforces his initiative to leave everything, study and work, to be with his mother. “I knew that she was not alone, but internally I I was convinced that mom’s partner was me. We were alone for many years, side by side. Since I can remember I saw his efforts and at 11 I began to earn money as a bricklayer’s assistant, so as not to ask him for anything.
Fabiana makes a joke without warning. “The closest ones call me Chucky, I have marks everywhere, but I don’t care because each scar is part of my story“.
Two major surgeries (colon and liver and then another liver), radiotherapy, a hundred chemotherapies and a transplant, draw a map on his body. She made friends with her brands, he loves them. “I suggested to Santi, instead, that he have cosmetic surgery, he is too young for such a scar, but he doesn’t want to know anything… He says that being like this defines his personality.”
They were hard years for Fabiana, who introverted was enduring every instance to which she submitted. “I plucked up my courage, I was facing something different in my life… I had always been able to do it alone, I always searched for myself in every job alone, I was seasoned in extreme situations… But this was different, it depended on the other, on the doctor. .. But I must say that I did not suffer pain, I do not remember”. Santiago agrees: “Mom never cried in all this time… Bah, only once and it was in 2017 when her dad died.”
The farewell video
On the night of November 30, 2021, the day before the transplant, Santiago and Fabiana had an early and light dinner and slept “very peacefully, against all odds.” At 5 in the morning on December 1 they got out of a taxi and arrived at the Favaloro Foundation. Months had passed of being on the run for studies and analyzes that gave the son the green light as a compatible donor.
Neither of them was clear that they were about to be part of a historical event in the history of Argentine medicine. Doctor Gondolesi had advanced something to them but without going too deep to avoid blurring them. “We were with our heads elsewhere, we did not think about the repercussions we would have, that happened when we were already discharged, and we could not believe that we had been the protagonists of such a surgery,” Santiago raises his eyebrows.
Just like her son, Fabiana was determined to carry out the transplant despite the fact that the word of her doctor in Coronel Suárez rattled her. “Fabiana, I would not undergo the transplant,” but the brave woman appealed that suggestion. “Thank you doctor, but I prefer to die trying, than to die with doubt. I already went through surgeries, radiotherapy, chemo… Is this life? No, I risk it, “she recalls.
For Gondolesi, this doctor’s suggestion “is due to fear of the unknown and fear of a risky transplant.” And he adds: “But the most important thing about this technique is that it can benefit other patients. Just keep in mind, it is not a massive technique, but we are talking about a therapeutic that is indicated in a select way and to a limited number. However, this developing It should be considered as a valid indication for doctors in Argentina to start taking it into account. evaluating potential patients.
“It was my first time in an operating room,” Santiago points out, “of course there were risks for both of us, but it calmed us down to know that it was the best choice, the one that gave us a chance for the future.” At 6 they were separated, each one headed for an operating room and there was no time for greetings or farewells. “With the help of a doctor, I made a little video for mom that showed it to her before the operation. Mine lasted about twelve hours and Mom’s about fifteen. They took something like 960 grams of liver from me, they told me they left me the bare minimum.”
Draw a smiling face Fabiana. “I have blurred images of that morning… Yes, we were mobilized but with control of the situation, it was not something else, but there was no fear… We arrived hugging and then we did what they told us… But then they It precipitated everything and I couldn’t greet him, but I remember the doctor who gave me his phone where my son’s message was”.
“‘Calm down, we’ll win this one again. Love you’. And there I fell asleep and when I woke up after the intervention they told me: ‘Don’t worry, your son is fine.’ And I woke up happy, because what Santi did exceeds the love of any son for his mother.”
MG