Dear Friends and Family,
Many of you know Jenny and I have become newlyweds of only a few months. As she has recently and unexpectedly become ill, we have right away been able to embrace the all familiar phrase in the marital vow “in sickness and in health”. Jenny has been diagnosed with auto-immune, non-alcohol related fatty liver disease (NASH). Jenny’s doctors and the members of the Medical Review Board for Liver Transplant have decided that her disease is serious enough to warrant liver transplantation and is her only option for survival.
Due to Jenny’s medical condition she has been unable to work. She is currently actively listed on the liver transplant waiting list. The progression of her disease will mean a tough challenge ahead for us and her care as Jenny waits for this life-saving surgery.
We have come to realize that funding this surgery is a monumental task. Even with insurance there are many expenses that must be covered out of pocket. Some of these are deductibles, co-pays and Jenny will be on a life-time of expensive anti-rejection medications.
In order to ease the financial burden, a fundraising campaign in Jenny’s honor has been established with HelpHOPELive, a nonprofit organization that has been assisting the transplanting community for 30 years. All donations are tax-deductible, are held by HelpHOPELIve in the South-Central Liver Transplant fund, and are administered by HelpHOPELive for transplant-related expenses only. For those who are able and would like to contribute:On behalf of Jenny, myself and our families, we thank you for your kindness, generosity and prayers.

Jeff Martinez
281-614-9126
[email protected]

October 8, 2013

Liver Transplant Program
A SUCCESS BY EVERY MEASURE
Some important information about our Liver Transplant Program:

More transplants – We are the largest liver transplant program in Houston’s world-renowned Texas Medical Center. Since 1998, our team has performed more than 1,000 liver transplants, making it one of the premier centers in the country.

Highest survival rates – Our liver transplant survival rate – the best indicator of the program’s success – is the highest in Houston. Our 1-year adult patient survival rate is 96.16%, statistically significantly higher than the national 89.89% expected survival rate*. When compared to other liver centers in the U.S. that do 40 transplants or more a year, our survival rates are the highest in the nation.

Shortest length of stay – Our patients also benefit from the shortest possible hospital stay and extremely low complication and re-transplantation rates, key indicators of a program’s success.

Improved access – Our rate of successful transplantation and low frequency of re-transplantation not only exceed the national averages, they have been achieved while perfecting the use of extended criteria donor organs – giving more patients access to this life-saving surgery.
A UNIQUELY QUALIFIED LIVER TEAM
Each of our 6 hepatologists is certified by the American Board of Internal Medicine in:

Internal Medicine
Gastroenterology
Hepatology and Liver Transplantation
Our transplant leadership team has worked together for more than a decade, providing the stability and longevity that are hallmarks of a successful liver transplant program.

In addition to liver transplants, we offer superior medical and surgical care for patients with any type of liver disease. Services include:

Hepatobiliary surgery
Treatment of liver mass and liver cancer
Treatment of chronic liver disease
Treatment of hepatitis B and C
Abdominal paracentesis
Evaluation and treatment of all forms of liver abnormalities

Our approach is comprehensive, collaborative and personal – all critical elements to ensuring the best possible outcomes and the highest quality of life for our patients. Weekly conferences are held to review individual cases, bringing together the best minds in surgery, hepatology, radiology, pathology, and oncology to collaborate on each patient’s care and treatment.

Our multidisciplinary approach also includes working closely with a variety of other specialties, including cardiology, nephrology and pulmonology, to improve patient outcomes and expedite treatment.

We offer a full range of support services – including extensive liver transplant education – to help patients and their families cope with their liver disease. Learn more about preparing for liver transplant surgery.

St. Luke’s Center for Liver Disease is advancing the field of liver transplantation and the treatment of liver disease through basic and clinical research. We conduct numerous clinical trials, including NIH funded studies that offer patients the latest therapies in:

Chronic viral hepatitis B and C – learn more >
Autoimmune liver diseases – learn more >
Non-invasive testing for liver fibrosis
Liver function testing – learn more >
Hepatic encephalopathy – learn more >
Treatment of liver tumors
Pediatric liver disease

Donate Life Texas
Donate Life America
Lodging close to St. Luke’s Episcopal Hospital
Parking close to St. Luke’s Episcopal Hospital
Preparing for Liver transplant surgery
Advanced Liver Therapies Research

Kidney Transplant Program
LVAD Program
Heart Transplant Program

www.stlukeshouston.com

October 8, 2013

St. Luke’s Episcopal Hospital and Baylor College of Medicine Joins Dr. Goss in Celebrating His Milestone in Liver Transplantation
Transplant News Articles

Published: June 10, 2010

St. Luke’s Episcopal Hospital and Baylor College of Medicine Joins Dr. Goss in Celebrating His Milestone in Liver Transplantation

The largest liver transplant program in Houston’s world-renowned Texas Medical Center, St. Luke’s performs approximately 75 liver transplants annually. Additionally, St. Luke’s liver transplant survival rate is the highest in the nation, with a one-year adult patient survival rate of 96.5 percent compared to the national expected survival rate of 89.38 percent.

Dr. Goss’s clinical interests lie in areas of adult and pediatric liver diseases. Dr. Goss performed the first pediatric split livers and adult living donor operations in the Houston area. Currently, he serves as the director of liver transplant programs at St. Luke’s Episcopal Hospital, Texas Children’s Hospital and the Michael E. DeBakey Veterans Administration Medical Center.

“This professional accomplishment is a testament to Dr. Goss’ commitment and dedication to the field of liver transplant and we join him in this milestone,” says Rise J. Stribling, M.D., medical director of St. Luke’s Liver Transplant Program. “I’m extremely proud of the St. Luke’s transplant leadership team. Each practitioner exemplifies professionalism and vast expertise, both of which are hallmarks of a successful transplant program.”

“The Michael E. DeBakey VA Medical Center’s program for the treatment of liver disease in the Veteran population is among the most advanced in the country. Dr. John Goss’ unique surgical talents, his team at St. Luke’s Episcopal Hospital, and the outstanding liver transplant program he established here have all played a fundamental role in its success,” said David H. Berger, M.D., M.H.C.M., Michael E. DeBakey VA Medical Center Operative Care Line executive. “I thank Dr. Goss for his unrelenting support and dedication in providing the best possible health care for our Nation’s heroes.”

The liver transplant team at St. Luke’s includes six hepatologists – each certified by the American Board of Internal Medicine in internal medicine, gastroenterology and hepatology and liver transplantation. Their multidisciplinary approach is comprehensive, collaborative and personal – all critical elements in striving for the best possible outcomes and the highest quality of life for patients. St. Luke’s liver transplant patients typically benefit from the shortest possible hospital stay and low complication and re-transplantation rates, which are key indicators of a program’s success. In addition, the team’s rate of successful transplantation and low frequency of re-transplantation exceeds the national averages.
Liver failure may result from health issues, such as hepatitis B and C, autoimmune hepatitis, cirrhosis, alcoholic cirrhosis, primary biliary cirrhosis, cryptogenic cirrohosis, primary sclerosing choalangitis, hepatocellular carcinoma, Wilson’s disease, primary hemochromatosis, non alcoholic steatohepatitis (NASH), Budd-Chiari Syndrome, acute liver failure and metabolic disease.

Goss completed his undergraduate studies at the University of Wyoming and received his medical degree from Creighton University in Omaha, Nebraska. He completed his general surgical training at the Barnes Hospital/Washington University School of Medicine General Surgery Program, under the direction of Samuel A. Wells, Jr., M.D. Goss then completed a two-year multi-organ transplant fellowship in the Division of Liver and Pancreas Transplantation at the University of California, Los Angeles School of Medicine under the guidance of Ronald W. Busuttil, M.D., Ph.D. Following the completion of this fellowship, Goss joined the UCLA Department of Surgery as an Assistant Professor. At this time, he was awarded The American Surgical Career Development Award, an American Liver Foundation Award and a Juvenile Diabetes Research Foundation Award. In 1998, Dr. Goss was recruited to Baylor College of Medicine to direct the liver transplant programs.
www.stlukeshouston.com

October 8, 2013

Non Alcoholic Fatty Liver Disease
NAFLD
Non-Alcoholic Fatty Liver Disease

IMPORTANCE
The liver is the second largest organ in your body and is located under your rib cage on the right side. It weighs about three pounds and is shaped like a football that is flat on one side.

The liver performs many jobs in your body. It processes what you eat and drink into energy and nutrients your body can use. The liver also removes harmful substances from your blood.

WHAT IS NAFLD?
Non-alcoholic fatty liver disease (NAFLD) is the build up of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to contain some fat. However, if more than 5% – 10% percent of the liver’s weight is fat, then it is called a fatty liver (steatosis).

WHO IS LIKELY TO HAVE NAFLD?
NAFLD tends to develop in people who are overweight or obese or have diabetes, high cholesterol or high triglycerides. Rapid weight loss and poor eating habits also may lead to NAFLD.

However, some people develop NAFLD even if they do not have any risk factors. NAFLD affects up to 25% of people in the United States.

Read how Nick Giordano, a marathon runner, was diagnosed with NAFLD.

RISKS
NAFLD may cause the liver to swell (steatohepatitis). A swollen liver may cause scarring (cirrhosis) over time and may even lead to liver cancer or liver failure.

SYMPTOMS
NAFLD often has no symptoms.

When symptoms occur, they may include fatigue, weakness, weight loss, loss of appetite, nausea, abdominal pain, spider-like blood vessels, yellowing of the skin and eyes (jaundice), itching, fluid build up and swelling of the legs (edema) and abdomen (ascites), and mental confusion.

DIAGNOSIS
NAFLD is initially suspected if blood tests show high levels of liver enzymes. However, other liver diseases are first ruled out through additional tests. Often, an ultrasound is used to confirm the NAFLD diagnosis.

TREATMENT
There are no medical treatments yet for NAFLD. Eating a healthy diet and exercising regularly may help prevent liver damage from starting or reverse it in the early stages.

See a doctor who specializes in the liver regularly
Talk to your doctor about ways to improve your liver health
Lose weight, if you are overweight or obese
Lower your cholesterol and triglycerides
Control your diabetes
Avoid alcohol
PREVENTION
There are ways to prevent NAFLD:

Maintain a healthy weight
Eat a healthy diet
Exercise regularly
Limit alcohol intake
Only take medicines that you need and follow dosing recommendations.
NASH
The more severe form of NAFLD is called non-alcoholic steatohepatitis (NASH). NASH causes the liver to swell and become damaged. NASH tends to develop in people who are overweight or obese, or have diabetes, high cholesterol or high triglycerides. However, some people have NASH even if they do not have any risk factors.

Most people with NASH are between the ages of 40 and 60 years. It is more common in women than in men. NASH often has no symptoms and people can have NASH for years before symptoms occur.

NASH is one of the leading causes of cirrhosis in adults in the United States. Up to 25% of adults with NASH may have cirrhosis.
www.liverfoundation.org

October 8, 2013

Autoimmune Hepatitis
Autoimmune Hepatitis
Explore this section to learn more about autoimmune hepatitis, including a description of the disease and how it’s diagnosed.

What is autoimmune hepatitis?

Autoimmune hepatitis is a disease in which the body’s own immune system attacks the liver and causes it to become inflamed. The disease is chronic, meaning it lasts many years. If untreated, it can lead to cirrhosis and liver failure.

There are two forms of this disease. Type 1, or classic, autoimmune hepatitis is the more common form. This is the form that mostly affects young women and is often associated with other autoimmune diseases. Type 2 autoimmune hepatitis is less common and generally affects girls between the ages of 2 and 14.

What causes autoimmune hepatitis?

Your immune system normally attacks bacteria, viruses and other invading organisms. It is not supposed to attack your own cells; if it does, the response is called autoimmunity. In autoimmune hepatitis, your immune system attacks your liver cells, causing long-term inflammation and liver damage. Scientists don’t know why the body attacks itself in this way, although heredity and prior infections may play a role.

What are the symptoms and complications of autoimmune hepatitis?

Often, the symptoms of autoimmune hepatitis are minor. When symptoms do occur, the most common are fatigue, abdominal discomfort, aching joints, itching, jaundice (yellowing of the skin and whites of the eyes), enlarged liver, nausea and spider angiomas (blood vessels) on the skin. Other symptoms may include dark urine, loss of appetite, pale stools and absence of menstruation. More severe complications can include ascites (fluid in the abdomen) and mental confusion. In 10%-20% of cases, autoimmune hepatitis may present with symptoms like an acute hepatitis.

How is autoimmune hepatitis diagnosed?

Autoimmune hepatitis often occurs suddenly. Initially, you may feel like you have a mild case of the flu. To confirm a diagnosis of autoimmune hepatitis, your doctor will use blood tests and a liver biopsy, in which a sample of liver tissue is removed with a needle for examination in a laboratory.

How is autoimmune hepatitis treated?

The goal of treatment is to stop the body’s attack on itself by suppressing the immune system. This is accomplished with a medicine called prednisone, a type of steroid. Often times, a second drug, azathioprine (Imuran) is also used. Treatment starts with a high dose of prednisone. When symptoms improve, the dosage is lowered and azathioprine may be added.In most cases, autoimmune hepatitis can be controlled but not cured. That is why most patients will need to stay on the medicine for years, and sometimes for life. Unfortunately, long-term use of steroid can cause serious side effects including diabetes, osteoporosis, high blood pressure, glaucoma, weight gain and decreased resistance to infection. Other medications may be needed to control these side effects.

Who is at risk for autoimmune hepatitis?

About 70 percent of people with autoimmune hepatitis are women, usually between the ages of 15 and 40. Many people with this disease also have other autoimmune diseases, including type 1 diabetes, thyroiditis (inflammation of the thyroid gland), ulcerative colitis (inflammation of the colon), vitiligo (patchy loss of skin pigmentation), or Sjogren’s syndrome (dry eyes and dry mouth).

Page updated: October 4th, 2011

www.liverfoundation.org

October 8, 2013

Jeff & I

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October 8, 2013

You are in great hands with Dr. Goss and St. Lukes. They did my liver transplant July 2011 and I could not be more happier and alive now. Have faith you will make it thru this journey.

Betsy - Houston

October 8, 2013

jenny, just know that you will be in my thoughts and prayers. i do miss the times we worked together and laughed so hard we had tears. hugs to you and jeff :-)

trish

October 8, 2013

Jenny I wish you all the best....I watched you grow up...from that little ponytail girl...and now you are a beautiful young woman...I will try to send a little bit...as I don't have much...but as always you will be in my prayers....love you sweetie...Cherie

Cherie (Yousef) Carpenter

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In honor of Jennifer Bukowski

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Help Hope Live
2 Radnor Corporate Center
Suite 100
100 Matsonford Road
Radnor, PA 19087

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