Somewhere inside Toronto General Hospital, Eugene Melnyk is no doubt savouring his second chance. Desperate for a life-saving liver transplant, the Ottawa Senators owner received his ultimate gift on Tuesday—less than a week after he reached out to the public, via his NHL hockey team, for a live organ donor.
Somewhere inside the halls of that same hospital, the anonymous donor is also in the early stages of recovery, his or her identity known only to medical staff and trusted loved ones. Not even Melnyk has any idea whose healthy organ is now his.
The turnaround was tight—and inevitably controversial. While so many others continue to languish on Ontario’s liver wait list (more than 200, at last count), Melnyk’s hockey club was able to mobilize the masses with a press-conference plea last Thursday. Promptly flooded with more than 500 volunteers willing to go under the knife, hospital officials spent the Victoria Day long weekend assembling an A-list of 12 top candidates. By Tuesday morning, the ideal donor was on a gurney being wheeled into surgery.
Did Melnyk’s wealth and fame afford him an unfair advantage? Did the 55-year-old use his clout to jump a queue? The answer is not as simple as it may appear.
Most donated organs come from the dead: people who take the time to register their wishes in advance. But in order to benefit from a deceased donor, a liver recipient must have the same blood type—and because Melnyk’s is extremely rare (AB), the odds of a match were slim to none. Live liver donation, which doesn’t require identical blood types, was his only realistic option.
In theory, all patients waiting for new livers can take advantage of live donation. They just have to find donors who fit the criteria—and are willing to let surgeons open their insides and slice out a chunk of their livers. (The organ grows back to full size in approximately three months.) Toronto General has performed nearly 700 such transplants, with the vast majority of live donors being friends or relatives of the patients.
In Melnyk’s case, he did ask “close friends and broader family” to be tested as potential candidates. Only when those results came back negative did he agree, albeit reluctantly, to go public with his story in a last-ditch attempt to extend his life.
That’s where things got murky.
Again, in theory, anyone can convene a news conference to solicit potential donors. There is no rule prohibiting it (unless dollars are offered in exchange for the organ). But not everyone has the influence and dedicated beat reporters of a professional hockey franchise, ensuring people actually attend the news conference. “There is a perception of unfairness because any other person on the liver transplant waiting list would not have a press conference to announce their need,” says Dr. Steven Paraskevas, a Montreal surgeon and president of the Canadian Society of Transplantation. “They could, but they may not have the same response.”
In other words, Melnyk did not jump to the front of the wait-list lineup. He simply had the resources to reach out to many more potential live donors than most—donors who otherwise would have never come forward to help someone else.
Toronto General received a similar surge in volunteers earlier this year, when the Wagner twins of Kingston, Ont., made news around the world. The girls’ adoptive parents, Michael and Johanne, used social media to share the girls’ plight—and their campaign went absolutely viral. One twin, Phuoc, received a portion of their dad’s liver; the other, Binh, was saved by an anonymous donor who, like Melnyk’s, came forward after reading all the headlines.
As Michael and Johanne said at the time, they weren’t going to wait around for livers to arrive. Determined to save their children, they went out and found the organs instead.
“Eugene Melnyk did the same thing anyone would,” Michael Wagner says today. “He worked hard to get to where he is, and I don’t begrudge him for using his position or influence.”
Wagner has been following this week’s developments, and he understands that many people don’t have the same connections to reach such a large swath of would-be donors. But that’s not necessarily unfair, he says. If anything, he thinks Melnyk’s case could end up helping others, too—just as his daughters’ story did. “Yes, he gets a liver out of this, but 500 other people sent their names in,” he says. “How many of those other people might give their liver to somebody else? What is the trickle-down effect?”
In the twins’ case, the effect was tangible. Some of the hundreds of volunteers who weren’t chosen to donate to the girls agreed to give to other sick children, and at least two young patients have already benefited, with more to come. “Those are people who are now off the list,” Wagner says. (Not to mention the huge awareness their story raised about deceased organ donation, and the need to register.)
More than anything, Wagner’s immediate thoughts are with the anonymous donor. He is the rare person who understands both perspectives: the overwhelming pain and sacrifice of being a live donor, and the indescribable gratitude felt by a family who benefits from an anonymous one.
A live liver donor must undergo a battery of medical tests, including an MRI, a CT scan and, if necessary, a biopsy. But the entire screening process is far more rigorous. Candidates are scrutinized by surgeons, psychiatrists and social workers—even doctors independent of the program, just to ensure they’re not being coerced. And the possibility of death is very real. Although Toronto General has never lost a live donor on the operating table, candidates are specifically warned that they may not wake up.
Post-surgery, a donor can expect a week-long stay in hospital, and up to three more months of at-home recovery while the liver slowly grows back. For the first few days, Michael Wagner could barely walk. A month after surgery, he still didn’t have the strength to pick up one of the three-year-old twins. “The first week is the hardest,” he says. “After that, I would say it is based on your own personal drive, and how fast you want to get well. By week two, I still couldn’t lift things and my stomach was very tender, but as every week went on I noticed my mobility, my strength and my stamina got better.”
He endured all that for his child. Imagine doing it for a complete stranger. “There are so many people out there willing to do this, and I really find it staggering,” Wagner says. “These are impressive people. I don’t know what motivates them, I really don’t.”
Doctors at Toronto General will provide more updates at a press conference Thursday morning. In the meantime, the Senators have released a brief statement, expressing the owner’s “immense gratitude to the anonymous donor and the donor’s family.”
As the Wagners know, there simply aren’t enough words to describe such appreciation.