Heading into Thanksgiving Day 2020, Tony Martin had one thing on his mind: smoking a 20-pound brisket for his family.

But at 3 a.m. that day, the call came in: VCU Health transplant coordinators had found Martin, who was on the transplant list due to liver cancer, a new liver. He and his wife were at the hospital by 6 a.m., and he received the life-saving transplant that afternoon.

“He battled a very stubborn liver cancer that we had a very difficult time shrinking down with [localized] treatments,” said Hannah Lee, M.D., a transplant hepatologist and co-director of VCU Health Hume-Lee Transplant Center’s liver tumor program.

Lee, with the help of the liver cancer and liver transplant teams, coordinated the Hampton man’s care. After surgery, the team found far more cancer in his liver that had been removed than they’d seen on imaging. There were multiple liver cancer lesions — so many, in fact, that had those lesions all shown up on MRI scans, Martin would not have met the transplant criteria due to the high risk of recurrence.

‘Divine intervention’ brings patient to Hume-Lee Transplant Center

Martin’s journey to receive a transplant began in 2010, when the Navy veteran went in for a routine physical as part of turning 50.

A scan revealed spots on his kidney, which turned out to be benign tumors known as adenomas. In follow up testing, doctors noticed spots on his liver, and he was referred to bariatric surgeon Arnold Salzberg, M.D. — a move Martin, who turned 62 this month, calls “divine intervention.” Salzberg, then practicing in Newport News, considered the spots precancerous.

In April 2012, the surgeon performed a liver resection on Martin to remove the spots and one-third of his liver, which regenerates over time. But after a check-up five years later, an abdominal scan revealed more liver spotting. Martin traveled to Roanoke, where Salzberg was now practicing, and had a biopsy.

Days later, Salzberg called with the news: Martin had liver cancer. “And before I could take my next breath, he said, ‘This is not a death sentence,’” Martin recalls. “Dr. Salzberg had already made my first appointment at the VCU Health Hume-Lee Transplant Center in Richmond.”

Salzberg trained at VCU’s School of Medicine and “hand delivered” Martin to Adrian Cotterell, M.D., a surgeon at Hume-Lee who would ultimately handle the Thanksgiving Day 2020 procedure.

After his transplant, Martin spent eight days in the hospital. But after being discharged, he contracted COVID-19 — a significant threat to transplant patients whose immune systems are purposefully weakened to ensure organs are accepted in the body.

Lee, the hepatologist and care coordinator, says high-risk patients like Martin are followed closely with magnetic resonance imaging (MRI) and computerized tomography (CT) scans for five years (he’s in year two). “But he’s done very well so far without any cancer recurrence,” she said.

Liver impacts kidneys

When doctors began the evaluation for Martin’s liver transplant, they found a cancerous spot that was later removed in 2019.

But he also had chronic kidney disease. Unfortunately, for patients with kidney conditions, a liver in failure is likely to push the renal system into that direction, too. After Martin’s 2020 liver transplant, doctors put him on dialysis, which required four hours three days a week for over a year. Hume-Lee found a kidney in May 2022, and he was transplanted.

While transplanting both a liver and kidney may seem a lot, it’s not unusual for liver patients like Martin who have underlying chronic kidney disease. “Usually within a year after liver transplant, patients are prioritized for kidney transplant,” Lee said.

Thankful for VCU Health

Now with Thanksgiving 2022 approaching, Martin sits back and reflects on where he was on Thanksgiving of 2020 and how far he has come.

“Without Dr. Salzberg pointing me to VCU, we probably wouldn't be having this conversation,” Martin said in a recent interview. “I have not had a bad experience with a medical person at VCU in the almost three years I’ve been there. I’m just now beginning to share my story without getting emotional.”

On Thanksgiving 2020, Martin was unable to finish that brisket he woke up thinking about. However, his daughter was able to take over, with some instructions from her father, who called her from his hospital bed to walk her through it.

This year, they get to work on it side-by-side.