In 2002, at the age of 7, Jasmine Williams was suffering from hyperoxaluria with oxalosis type 1, a rare genetic disorder in which a defective liver enzyme impairs kidney function. At the Children’s Hospital in New Orleans, the little girl and her family were told that Jasmine was in the unfortunate position of needing both organs replaced—her liver and a kidney. The following year, she found herself at Texas Children’s Hospital under the care of Dr. John Goss, feeling scared yet ready for her dual-organ surgery. “He talked to me and let me know what to expect,” Williams, now 18, recalls. “He helped me understand what I was going through.”
Just a few years prior, Williams surely would not have been sent here for her operation. In 1997, just six liver transplants were performed at TCH. The following year, when, after completing a fellowship at UCLA, Goss moved to Houston, starting liver-transplant programs at Houston Methodist and Baylor and taking over at Texas Children’s, only one doctor in the city was performing such transplants, pediatric or otherwise. “There was a surplus of organs,” recalls Goss. “There were livers here being shipped to other parts of the country, patients that were here that were being sent elsewhere.”
After Goss arrived, Houston got to keep its livers. That first year, he and his team were responsible for 10 transplants, including one for a child at TCH. The number would explode from there. “Since moving to Houston I have done over 1,300 liver transplants, and of those, over 300 have been children,” says Goss. According to a spokesman, 315 liver transplants have been performed at TCH alone since 1998, with 39 done in 2012—more than any other pediatric hospital in the nation. Texas Children’s one-year liver transplant–surgery survival rate is 98 percent.
Goss, who now teaches at Baylor in addition to leading the transplant programs at TCH, St. Luke’s, and the VA, has performed several firsts in our city, all related to that most miraculous and fascinating thing known as the liver, the only internal organ capable of regenerating itself. (Even the ancient Greeks seemed to understand its powers. In mythology, Prometheus’s liver is eaten every day by an eagle but grows back each night.) It’s the organ’s powerful regenerative capacities that allow, say, an adult liver from an organ bank to be split between another adult and a child, or a living adult to give part of his liver to a child. Goss was the first doctor to perform these surgeries in Houston, as well as the first to do rarer dual-organ lung/liver and heart/liver transplants.
And the progress continues. “It’s a big operation, yes, but as we’ve gone on in time, we’ve gotten much better at it—the instruments are better, the antibiotics and anesthesia are better, as is our understanding of how to do the operations,” he says. “Our handling of problems associated with liver disease is better.” No one can live very long without a liver, so in a transplant situation, time is of the essence. “When I was a fellow, I thought you were really good if you got it sewn in 40 to 50 minutes,” says Goss. “Now it’s hopefully only out for a half hour, 20 or 30 minutes.”
Why specialize in liver transplantation? “You can make people better,” Goss says simply. “You can cure their disease, you can get rid of it. When I was a resident, I liked it because it actually made the patients’ disease go away. You can fix it.”
You certainly can. Jasmine Williams graduated from high school this year and plans to major in biomedical sciences. And recently she had the opportunity of a lifetime at the World Transplant Games in South Africa, where she competed in bowling and badminton. “I’ve been practicing a lot,” she says. “I’m pretty thrilled.”