VCU news

By Dan Carrigan

Edward Foster is 69 years old, a proud patriarch with eight children and 21 grandchildren. He still hosts a family dinner at his Henrico County home every Friday night and has a passion for attending collegiate sporting events across the country in which his grandchildren participate. An accomplished conservatory-trained pianist, he even taught one of his grandsons living out of state how to play via FaceTime. To call Foster a family man would be an understatement.

“Family is everything,” he said.

And when Foster needed his family the most, they were there.

For decades, Foster had battled a chronic disease that was pushing his liver to failure. He suffered from primary sclerosing cholangitis, a condition in which the body attacks and inflames the bile ducts and causes liver failure. Its cause is unknown.

“I was getting to the last leg. I knew it. I couldn't let my family know, but I knew,” Foster said.  

At a Friday dinner, he broke the news that he needed a transplant. He was faced with possibly months, if not years, on the national transplant waitlist waiting for a deceased-donor liver.

There was another option — a living-donor liver transplant. For prospective recipients, living-donor liver transplants reduce the time and stress of being on the national transplant waiting list. The organ from a living donor is often healthier and so are recipients since they don’t have to spend as much time waiting for an organ. In addition, live donors add organs to the donor pool, increasing the number of transplants possible each year amid a national organ shortage.

The procedure is complex, and involves a multidisciplinary team of specialists. For the donor, the surgery entails removing part of the liver, which is then transplanted into the recipient.

“These are healthy patients who are in general trying to help a friend or family member or someone they have a relationship with, with a life-threatening disease,” said David Bruno, M.D., surgical director of adult and pediatric liver transplantation at the VCU Health Hume-Lee Transplant Center, which has been ramping up its reimagined living liver program. “It’s nothing short of a heroic act.”

Finding a match

Members of Foster’s large family were more than willing to donate.

After a number of tests, his youngest son, 40-year-old Edward “Rick” Foster Jr. of Henrico County, was a match.

“It’s my dad. I love him a lot,” Rick Foster said. “My parents worked really hard at taking care of us. Education wise, sustainability life wise, and emotionally always very supportive. So to be able to do anything, it's an honor.”

Bruno joined Hume-Lee as part of the revitalization of the center’s living liver program. Also part of this effort, living liver donation expert Vinay Kumaran joined Hume-Lee as living liver surgical director. His resume includes more than 700 living liver donor cases. The Fosters affectionately refer to Kumaran as “Dr. K.” In addition to his role in coordinating and planning Edward and Rick Foster’s procedures, Kumaran also would be the lead surgeon for the removal of a portion of Rick Foster’s liver.

In mid-July, the team’s hours of planning went into action. Kumaran and the Hume-Lee team removed the right lobe of Rick Foster’s liver and transplanted it into his father. Both spent time recovering in Hume-Lee’s dedicated transplant unit with family members by their sides.

The procedures marked the first living liver transplant at VCU in nearly five years.

“The first case is always something you remember, the first case at an institution,” Kumaran said. “It’s nice to have the first case and both are doing well.”

These are healthy patients who are in general trying to help a friend or family member or someone they have a relationship with, with a life-threatening disease. It’s nothing short of a heroic act.

‘The right time’

The procedure marked another chapter in the Hume-Lee Transplant Center’s storied history of transplantation, which includes Virginia’s first liver transplant and the first-ever “reduced-size” orthotopic liver transplant using a liver from an unrelated living donor.

"God is still in the healing business,” Edward Foster said. “You have to have that faith that it's going to happen, and it's all in your plan. And if you can believe that, the right people will be in place for you at the right time. And VCU was the right place. God knows it was the right time.

“I had this eighth child, and that's the one that could step up to the plate. Most perfectly matched mind, body,” Foster said tearfully.

Now Edward and Rick Foster share a unique father-son bond through a liver — an organ that somewhat miraculously grows to its original size and function in both the donor and recipient in generally four to six weeks. They made Foster family and Hume-Lee history as the program works to help even more families through living liver donation.

“Now more than ever, we've assembled a team with just vast experience in living-donor liver transplantation. We're doing that so we can become leaders in this country for living-donor liver transplant,” Bruno said. “We want to try to serve the patients, not just in the state of Virginia, but we want to have patients from the region and nationally coming to VCU so we could offer them this service.”

For the Fosters, the successful surgery means more time with each other.

“I appreciate everything they did for me,” Edward Foster said of the VCU team.

“They became part of [my] hospital family.”