A Call to New Life
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John Halvey built a life fueled by drive and momentum. Ambitious and precise, he thrived in a fast-paced world, rising to prominence as general counsel of the largest hedge fund and one of the leading asset management firms.
But John’s life took a sudden, terrifying turn during a football game in West Virginia when an unexpected diagnosis brought his fast-moving world to a standstill.
While cheering on his team, John began experiencing flu-like symptoms. A call to his physician resulted in a preliminary diagnosis of a kidney stone. The pain intensified, leading to an emergency flight home to the closest hospital in Connecticut.
There, the diagnosis expanded. John not only had a kidney stone but was also diagnosed with end-stage liver disease, also known as cirrhosis, a condition characterized by advanced scarring of the liver.
In that situation, you don’t have all the time in the world, and I wanted to be at the place that I believe is the best in the world.
— John Halvey
He entered a program in which clinicians scanned his liver a few times each year to check his liver function, with the expectation that he would eventually need a liver transplant. After a routine scan, he received a call informing him that his care team had found hepatocellular carcinoma, the most common type of liver cancer.
“You never want that type of phone call,” John says. “But adding in the fact that I got the call while the world was shutting down because of COVID-19 made it even more daunting.”
John’s situation was complex. He was dealing with not just liver cancer but also fatty liver disease, a narrowed heart valve, coronary artery disease and inactive tuberculosis. John and his wife, Elizabeth, sought a second opinion at Mayo Clinic.
“In that situation, you don’t have all the time in the world, and I wanted to be at the place that I believe is the best in the world,” John says.
A Multidisciplinary Approach
In late March 2020, Robert Huebert, M.D., transplant hepatologist, met with John to confirm his cancer diagnosis and initiate a comprehensive workup.
“He had a very complex set of medical problems, and he brought the same intensity that propelled his career and channeled it toward his medical problems,” Dr. Huebert says. “He really pushed the team to be the best doctors we could be to try to help him, and yet he always maintained his characteristic humility and his disarming sense of humor.”
A team of specialists from hepatology, transplant surgery, interventional radiology, cardiology and infectious diseases convened to develop a personalized treatment plan. John's liver function was still relatively good, making him a lower priority on the transplant waiting list, even if he were to be listed immediately.
The team's approach was multifaceted. First, they would treat John’s two heart problems — aortic stenosis and coronary disease — and then his latent tuberculosis. Because John’s tumor was small, they opted to allow it to grow during this time to a size that would eventually qualify John for additional Model for End-Stage Liver Disease (MELD) priority points. MELD scores determine the urgency of a patient's need for a liver transplant.
“It might seem a little counterintuitive to let the cancer grow,” Dr. Huebert says. “A six-month waiting period gives us the chance to observe the behavior of the tumor — if it’s particularly aggressive during that time, we know that those patients often won’t do well with transplantation.”
John was added to the transplant list in April 2020. Mayo Clinic physicians offered a stark contrast to what John had experienced elsewhere.
“At other hospitals, it kept being described to us as ‘if you get a transplant,’” Elizabeth says. “From the very first time we went into Mayo, it was ‘when you get a transplant.’ It’s such a small word change, but it made a huge difference.”
Waiting for the Call
By late 2020, anticipating the transplant, John and Elizabeth relocated to Rochester, Minnesota. John experienced two "dry runs" — situations where a donor liver became available but proved unsuitable upon closer examination.
Then, on January 18, 2021, the call came. John and Elizabeth headed to the hospital for another potential liver.
The liver for John was originally turned down by the procuring team at another hospital due to its high fat content. However, Mayo Clinic’s expertise allowed them to confidently proceed.
At other hospitals, it kept being described to us as ‘if you get a transplant.' From the very first time we went into Mayo, it was ‘when you get a transplant.’ It’s such a small word change, but it made a huge difference.
— Elizabeth Halvey
"This was a collaborative effort, leveraging our extensive experience," says Timucin Taner, M.D., Ph.D., transplant surgeon. "As a high-volume transplant center, we utilize a large number of organs for transplantation, and we do so with efficiency. Our clinical and research experience, coupled with sustained high transplant volume, allows us to handle the most challenging cases."
John’s surgery was a success, and he was discharged just four days later.
“A whole bunch of stars had to align perfectly to get John through,” Dr. Huebert says.
A New Beginning
Four years after his transplant, John is thriving. He’s lost 50 pounds, and his liver shows no signs of fat accumulation, just as Dr. Taner predicted.
"Many people think a transplant is the finish line," Elizabeth says. "But it's really just the starting point. We were determined to make it work, so we embraced many lifestyle changes.”
John and Elizabeth have embarked on a wellness journey together. Because of John’s lifestyle changes, he’s been able to eliminate many of his daily medications.
“It may well turn out that cancer was the best thing to happen to me because it drove me toward a healthier life,” John says. “I ended up with a better liver than I started with.”