But when he came home from school one day and began vomiting, Jacob's mom and dad took him to the local hospital emergency room, where doctors found alarming numbers in his lab work.
Liver numbers, also called liver enzymes, are indicators of liver function. Jacob's liver numbers, which are less than 40 in a healthy child, were extremely high — in the thousands. Jacob was also severely coagulopathic, which means his blood was unable to clot properly.
Severe and sudden onset liver failure
Jacob was immediately transferred to the Pediatric Intensive Care Unit (PICU) at Children's Hospital of Philadelphia (CHOP), where doctors diagnosed him with fulminant hepatic failure — liver failure with a very rapid onset. Fulminant hepatic failure is rare, and generally doctors are not able to ascertain the cause.
CHOP's Liver Transplant Program team was called in to meet with Jacob's parents, Linda and Timothy, on March 1. Team members discussed the possibility of liver transplantation with them, but told them the next few hours would be crucial; Jacob would get much better — or much worse. The Jowetts were reeling from the news, especially because they had assumed both children simply had respiratory infections.
Liver transplant for Jacob
The next day, Jacob's numbers were even higher. Worse yet, he quickly became encephalopathic, meaning he was confused and disoriented because his liver was unable to filter out toxins before they reached his brain.
Fortunately for Jacob, a donor liver became available within a few short hours.
Jacob received his new liver — a split liver from a deceased donor — that night. Kim M. Olthoff, MD, performed the nine-hour surgery, which went extremely well.
"As with all fulminant cases, this happened so fast," remembers transplant coordinator Cathy Goodsell, MSN, CRNP. "We met him and his parents one day and transplanted him the next. When we first met him, he was so sick and scared that we didn't have a handle on his personality or what he was like."
Back to his playful self
Today, you would never know that Jacob Jowett got so sick, so fast. His recovery went smoothly. He was in the PICU for only three days and was discharged on March 15, 2001 — just 13 days after his transplant.
When Jacob came back after discharge for his first clinic appointment, Goodsell says she was amazed at his personality. "He is very cute, with piercing blue eyes and dimples," she says. "He has a great imagination and that boy can talk."
Jacob likes comic books, army characters, his best friend, Angelina, and, most of all, the movie "Grease." Goodsell says he watched it every day during his hospitalization, has the movie memorized, and likes to act it out when he thinks no one is watching.
Jacob returns only for routine clinic visits and is back to his talkative, playful self. He's attending fourth grade. He is down from seven medications to just two, and has had no complications.
Originally posted: June 2009