Facing death, Jeff Cross and Lily Cheng had run out of options. But a rare "domino" liver transplant, involving a living donor, gave both a future.    

    面對死亡，杰夫·克羅斯和程莉莉已經(jīng)沒有其他選擇了。但是一個罕見的"多米諾"式肝臟移植(涉及到一位活人器官捐獻者)，卻給兩人帶來了新的生機。
 
    Since last spring, Jeff Cross, 29, had been tormented by night sweats, a side effect of the rare genetic illness that threatened to kill him unless he got a new liver.
  
    從去年春天起，29歲的杰夫·克羅斯天天被盜汗所困擾，這源于一種罕見的基因遺傳病變，除非他獲得一個新的肝臟，否則疾病將威脅他的生命。
 
    Cross's disease, familial amyloidosis, prevents the liver from breaking down a protein called transthyretin. It takes about three decades for the substance to accumulate to dangerous levels, at which point it can destroy the victim's nerves and organs. Because of his background he had no idea that he carried a deadly gene. Born is South Korea, he was adopted as a 4-year-old orphan by Peter Cross, and his wife, Margaret. After receiving a degree in economics from the University of California in 1995, Cross went to work in customer service for a investment firm in San Mateo. There he met JoAnna Poblete, now 27. In March 1998 the couple moved in together, and in August '99 they relocated to Los Angeles. But Cross soon developed a cough so violent it made him vomit. His left foot hurt so badly that he could barely walk. Then he lost 25 lbs. and most of the sight in his right eye.

    克羅斯患有一種其家族特有的淀粉樣變性疾病，它使肝臟無法分解一種叫做轉體基因的蛋白。這種物質(zhì)積累約30年方可達到危險水平，屆時它將破壞患者的神經(jīng)系統(tǒng)和器官。由于他特殊的成長經(jīng)歷，他并不知道自己攜有致命基因。他出生在南韓，4歲時被彼得·克羅斯和他的妻子瑪格麗特收養(yǎng)，當時他已經(jīng)是一個孤兒。1995年獲得加利福尼亞大學經(jīng)濟學學位后，克羅斯在圣馬特奧的一家投資公司的顧客服務部工作。在那里他結識了現(xiàn)已27歲的喬安娜·波夫萊特。1998年3月，他們倆搬到一起，翌年8月喬遷至洛杉磯。不久克羅斯患了咳嗽癥，他咳得非常厲害并時常嘔吐。他的左腳劇痛難忍導致行走困難。接著體重銳減25磅，右眼失去大部分視力。 

    Then in April Dr. Marc O.Yoshizumi, professor of ophthalmology at UCLA's Jules Stein Eye Institute, suggested Cross get tested for amyloidosis. Initially Cross was diagnosed with a different, incurable form of the disease, which would likely have killed him by age 40. In search of a second opinion, Poblete tracked down amyloidosis experts on the Internet. Dr. Morie Gertz, chairman of the hematology division at the Mayo Clinic responded, and after Cross flew out for an exam,Gertz delivered a new conclusion:familial amyloidosis, which affects about 1 in 4 million people and can be cured with a new liver." We were elated," Cross says.

    4月，加利福尼亞大學洛杉磯分校朱爾斯·斯坦視力協(xié)會眼科教授馬克·歐·喜純醫(yī)生建議克羅斯就淀粉樣變性做測試。最初克羅斯被診斷為患有另一種不可治愈的疾病，最多只能活到40歲。為尋求其他專家的不同意見，波夫萊特在網(wǎng)上查詢淀粉樣變性方面的專家。梅奧診所血液部主任莫里埃·格茨醫(yī)生回答了她的問題。當克羅斯做了一次抽血檢測后，格茨提出了一個新的結論：家族淀粉樣變性，其發(fā)病幾率大約是400萬分之1，可采用肝臟移植來治愈。克羅斯說："我們聽后非常高興。"
 
    That joy proved short-lived. Cross's protein-damaged heart was in such bad shape, doctors said, that it could give out within six months. Yet because his liver was functioning well, aside from its one defect, he would be a lower priority than many candidates for a cadaverliver transplant. A desperate Poblete e-mailed 100 friends and family members, asking if anyone with the same blood type as Cross, O positive, would be willing to help.

    但那份歡樂是短暫的。醫(yī)生們說，因蛋白質(zhì)壞損，克羅斯的心臟狀況極差，將會在6個月內(nèi)衰竭。由于他的肝臟除了自身遺傳缺陷外，運轉功能仍然良好，因此在眾多等待肝臟移植的候選人中并不具有任何優(yōu)先權。絕望的波夫萊特向100名朋友和家人發(fā)出電子郵件，詢問是否有像克羅斯一樣是O型血的人愿意伸出援助之手。
 
    No one in Cross's adopted family proved a match, so Doug Andrews stepped forward. Andrews is youth pastor of the First Baptist Church of San Mateo. Though he wasn't close to the ailing man, his wife, Krissie, 28, a product manager for a medical-device company, had been pals with Cross since kindergarten.

    在收養(yǎng)克羅斯的家庭成員中無人與其血型相配，于是道格·安德魯斯挺身相助。安德魯斯是圣馬蒂奧浸禮會的年輕牧師。他本人與病魔纏身的克里斯并不熟識，但他28歲的妻子--一位醫(yī)療器械公司的產(chǎn)品經(jīng)理，從幼兒園時起就同克羅斯是好朋友。
 
    In so doing he gave 43-year-old Lily Cheng a new chance at life as well. Born in Beijing, Cheng was a professional dancer before getting married and having a son, Jack, now 15. In 1989 she got into the import business and three years later moved to the U.S.. After divorcing her husband in 1996, she settled with Jack in an apartment outside L.A. and went to work for an import-export business that requires her to make frequent trips to China.

    安德魯斯的義舉還給43歲的程莉莉帶來了一個新生的機會。程莉莉出生在北京，在她結婚并生下今年已15歲的杰克之前，曾是一名專業(yè)舞蹈演員。1989年她開始做進口生意，3年后搬到美國。1996年她與其丈夫離婚后，同兒子杰克住在洛杉磯市郊的一座公寓中，為了進出口生意需要經(jīng)常往來中國。

    It was on one such excursion in July that Cheng, who still felt more comfortable with the medical system in her native land, decided to get a routine physical." The doctor saw something on my liver right away," says Cheng. Although she still had no symptoms, specialists back in the U.S. delivered a grim prognosis. Says Dr. Busuttil:" She would probably have been dead within a year." By the time she became eligible for a cadaver liver, the cancer would have spread throughout her body.

    這是7月里的一個短期旅程，程莉莉來到她的出生地北京，由于對當?shù)氐尼t(yī)療體制更適應一些，于是決定做一次常規(guī)體檢。程說："醫(yī)生立即在我的肝臟上發(fā)現(xiàn)了問題。盡管她當時尚未有癥狀，但回到美國后專家對其病情的預測卻令人擔憂。比敘蒂醫(yī)生說："她可能在一年內(nèi)離開這個世界。"待到她得到一個適合的活體肝臟時，肝癌細胞早已擴散到全身。
 
    Even harder than hearing that news was breaking it to her only child. " She said she wanted to see me grow up and she loves me very much," Jack recalls. " I don't usually cry, but I cried when she told me." Cheng then returned to China to see her parents, for what she feared might be the last time. There she received the call from UCLA telling her she was a perfect candidate for Cross's liver, since it was similar in size to hers and their blood types matched. And because Cross's amyloidosis was so slow-acting, she would be in her 70s before symptoms set in.

    比這個更痛苦的是把這個消息告訴她惟一的孩子。杰克回憶道："她說她想看著我長大，她非常地愛我。我平常不愛哭，但當時我哭得很傷心。"程接著回到中國去看望雙親，她恐怕這可能是最后一次了。但在北京她接到了來自加利福尼亞大學洛杉磯分校的電話，告訴她克羅斯的肝臟同她的肝臟大小相似，且他們的血型相配，她是接受克羅斯肝臟移植的完美候選人。由于克羅斯的淀粉樣變性發(fā)展緩慢，疾病發(fā)作之前她將是70多歲的人了。
 
    With Andrews, Cross and Cheng lined up, doctors scheduled the triple surgery. The surgeons would not be sure until they opened up Andrews that his liver was healthy enough to be transplanted. Even if it was, Cross had a 40 percent chance of dying on the operating table because his heart had grown so weak.

    安德魯斯，克羅斯和程將以此為序接受醫(yī)生們計劃的3人一組的外科手術。在外科醫(yī)師打開安德魯斯的體腔確定其肝臟健康可進行移植前，大家對這次手術的成功性都難以把握。而且即便如此，由于克羅斯的心臟十分虛弱，他死在手術臺上的概率達40％。
 
    But it was Cheng who carried the most risk. Not only did doctors fear her cancer might have already spread beyond her liver -- thereby rendering a transplant futile -- but two nights before the surgery, she came down with a cold. Because transplants weaken the immune system, they cannot be performed on sick patients.

    然而程的風險最大，醫(yī)生擔心她的癌細胞已經(jīng)擴散，會使移植徒勞無功，更糟糕的是在手術前兩個晚上，她患了感冒。由于移植會使免疫系統(tǒng)變?nèi)酰�病人在此情況下不能施行手術。

    Cheng immediately checked into the hospital, and doctors had her infection-free within 24 hours. She met Cross and Andrews for the first time when they arrived on Oct. 1, trading jokes and encouragement with the men in Cross's room.

    At 5 a.m.on Oct.2,Cross and Andrews were wheeled into separate operating rooms,each staffed by a team of eight doctors and nurses.(Cheng would follow at 9 a.m.)First Dr.Ghobrial opened up Andrews. After seeing that his liver was in fine shape, Ghobrial sliced off a little more than half of the organ's right side. In the room down the hall, Dr. Busuttil began to remove Cross's liver.

    程立即住進醫(yī)院，醫(yī)生們在24小時內(nèi)將其感冒治好。克羅斯和安德魯斯于10月1日到達，程與他們第一次見面，她輕松地開著玩笑并表示鼓勵。

    10月2日凌晨5點，克羅斯和安德魯斯分別被送進手術室，每個手術小組配備8名醫(yī)生和護士(程的手術將于上午9：00開始)。賈布里勒醫(yī)生為安德魯斯實施手術。在確認他的肝臟健康完好，賈布里勒醫(yī)生切下了右邊肝臟的多半部分。在大廳南側的房間里，比敘蒂醫(yī)生開始切除克羅斯的肝臟。

    At 11:30 a.m.Busuttil connected the partial liver from Andrews to Cross's now-empty liver cavity, stitching together veins, arteries and bile ducts. An hour later, after receiving word that Cheng's cancer was limited to her liver, Ghobrial moved to the third operating room to help implant Cross's liver into Cheng.

    By 5:30 p.m. all three patients were in recovery. " There are often hitches in surgery," says Busuttil, " but with this particular one, it was like clockwork." Which is exactly what Cross's fiancé e told him as soon as he woke up. " Jeff, you made it, you're okay," said Poblete. Cross, on a respirator, responded the only way he could -- with tears.

    上午11：30，比敘蒂將安德魯斯的部分肝臟植入克羅斯的肝腔，縫合靜脈、動脈和膽管。1小時以后傳來消息說，程的腫瘤沒有從肝臟擴散。賈布里勒來到第三間手術室，幫忙將克羅斯的肝臟移植到程身上。

    下午5：30，3名病人都處于康復狀態(tài)。比敘蒂說："在外科手術中經(jīng)常會有事故發(fā)生。但是這個特殊的手術卻像時鐘一樣精確。"當克羅斯剛剛醒來，他的未婚妻波夫萊特告訴他說："杰夫，手術成功了，你很好。"克羅斯戴著一個呼吸器，只能用熱淚作為回應。
 
    A few complications cropped up post-surgery. Andrews spent an extra four days in the hospital until the nerves in his liver began functioning fully, while Cheng's bile duct had to be restitched after it developed a slight leak. Cheng, meanwhile, has a 60 to 70 percent chance of surviving five years cancer-free. And though she, like Cross, will take immunosuppressant drugs for the rest of her life to prevent rejection of the new liver, she's thrilled to have been given more time with her son. "Every time I see Jack," she says, " I feel grateful."

    手術后出現(xiàn)了一些并發(fā)癥。安德魯斯因此在醫(yī)院又多住4天，直到其肝臟的神經(jīng)開始完全正常工作。而程的膽管因出現(xiàn)泄漏而不得不再次縫合。程有60％至70％的可能在5年內(nèi)不會出現(xiàn)癌癥。盡管她像克羅斯一樣，為了防止新肝臟的排異性，將終身服用抑制免疫力之藥物。但對于能有更長的時間同她兒子在一起，她仍感到很興奮。她說："每當看到杰克，我就心懷感激。"

    Cross, too, is counting his blessings. He was planning to return to work this month, and because doctors give him an 85 percent chance of surviving the next year, he and Poblete feel confident enough to plan a fall wedding. His eyesight has been restored, following a separate operation, and now Cross is undergoing physical therapy three times a week to rebuild the strength in his nerve-damaged feet. That should allow him to walk down the aisle and to fulfil another dream of Poblete's." All I've ever wanted,"she says," is for him to be able to dance all night.

    克羅斯也不斷地作感恩禱告。他計劃本月重返工作崗位。由于醫(yī)生告訴他有85％的機會活過明年，他和波夫萊特充滿信心，計劃舉行秋季婚禮。又經(jīng)過一次手術后，他的視力恢復了。現(xiàn)在克羅斯一周3次接受理療，以使他神經(jīng)受損的雙足逐漸恢復力量，能夠沿走廊漫步，進而實現(xiàn)波夫萊特的另一個夢想。她說："我曾經(jīng)夢想的，就是他能夠整夜地跳舞。"