Nurse Cami Loritz Gave Part of Her Liver to a Boy She Had Never Met

Originally published 2020-01-11. Dates, ages and announcements in this article refer to January 2020.

In spring 2019, a young wrestler from Wrightstown, Wisconsin, went from healthy schoolboy to a child in acute liver failure within about a week. Brayden Auten needed a new liver fast, and no suitable deceased donor was available. The person who saved him was Cami Loritz, a 24-year-old transplant intensive-care nurse at Froedtert Hospital in Milwaukee, who had never met him. She gave him part of her own liver.

The photos of the two of them proudly showing their matching surgical scars went around the world. Here is the full story, along with what living liver donation actually involves for donor and child.

A sudden illness and a race against time

Brayden's parents, Ruth and James Auten, describe him as an active, sporty boy. That season he had become the youngest wrestler from Wrightstown to qualify for the state wrestling meet. Then, in April 2019, he came home from school feeling ill. By the following night he had been admitted to Children's Hospital of Wisconsin in Milwaukee (now called Children's Wisconsin).

Doctors found that an aggressive virus, which they were not able to identify, was destroying his liver. Within a week he was fighting for his life, and the transplant team told the family he would go on the waiting list for a new liver that same night. At first, no match turned up.

His father later told CBS 58: "It was absolutely terrifying to not know how much time you have left with your child."

Cami Loritz and Brayden show their surgical scars in a hospital corridor. Her T-shirt carries the "Donate Life" slogan used by US organ donation campaigns.

The nurse who was already preparing to donate

Cami Loritz's offer did not come out of nowhere. She grew up in Denmark, Wisconsin, graduated in nursing from Winona State University in Minnesota in 2017, and took a job in Froedtert's transplant ICU. A few months before that, her father had donated a kidney to his brother, so she had seen the process up close in her own family.

Working with transplant patients every day, she decided to be evaluated as a living organ donor and was cleared. She was getting ready to give part of her liver to a child on the transplant list when Brayden's case came up. Froedtert is the children's hospital's next-door neighbour in Milwaukee. The team called her in, found that she was also a match for Brayden, and asked whether she could donate that same week instead of waiting. She agreed.

Loritz told reporters she did not think it was fair for an eight-year-old to die that way, and she was blunt about the stakes: "He would have died."

Donor and recipient together during a hospital visit. Loritz met the Auten family for the first time about a week after the operation.

Surgery, recovery and a very big hug

The operation was a partial liver transplant. Surgeons removed a section of Loritz's healthy liver and placed it in Brayden after taking out his failing organ. Both procedures went well. Loritz met the boy and his parents for the first time about a week later.

Brayden spent roughly two months recovering in Milwaukee and went home in July 2019. At a later check-up his doctors told him he could return to sports, and he greeted Loritz with a long hug. Reports at the time gave his age as seven (he was then in second grade) or eight, depending on when the story was written.

His mother put the family's feelings simply: "She's a true miracle." The Autens say they now consider her part of their family.

A piggyback ride in the woods. The pink lettering on the T-shirts reads #AutenStrong, the hashtag the family used while Brayden was ill.

How living liver donation works

The liver is the only solid organ in the human body that can regrow. That is what makes living donation possible: a healthy adult can give away part of it and, within weeks, the remaining tissue grows back towards its full size and function. The transplanted section also grows inside the recipient.

• How much is taken. For a child, the donor usually gives a smaller piece, about a fifth of the liver (segments 2 and 3, on the left side). Adult recipients need a larger graft, often the right lobe.
• Regrowth. In donors, the liver typically returns to near-normal function within about four to six weeks, and most donors are fully recovered within two to three months.
• A short history. The first successful living-donor liver transplants were reported in 1989, by Silvano Raia in São Paulo and then by Christoph Broelsch in Chicago, who transplanted part of a mother's liver into her two-year-old daughter.

Living donation matters because deceased-donor livers are scarce, and children have the added problem of needing an organ small enough to fit. A living donor allows surgeons to schedule the operation before a child becomes too sick to survive it.

The two scars side by side: Brayden's from receiving the graft, Loritz's from giving it. Both operations are major abdominal surgery.

Who can donate, and what are the risks?

Not everyone who wants to help can donate. Transplant centres run detailed medical and psychological evaluations. In general, donors need to be healthy adults (usually roughly 18 to 60) without significant liver, heart or kidney disease, uncontrolled high blood pressure or diabetes, and with a compatible blood type and suitable body size. They also have to be donating freely, not for payment. Many programmes prefer a close relationship with the recipient. Loritz had volunteered to help a child she did not know, which is far less common.

The surgery carries real risks for a healthy person. Published case series report complications in roughly one donor in ten, most often bile leaks, infections or slow stomach emptying, and these are more frequent when the larger right lobe is removed. Deaths among donors are rare but not zero; reported rates are well under one per cent.

Anyone thinking about becoming a living donor should talk to a doctor and contact a transplant centre directly, which can explain its own criteria and outcomes. Signing up as a deceased organ donor, through a driving licence or a national registry, is a simpler step that anyone can take today.

Myths and facts about liver donation

• Myth: you need to be related to donate. Family members are the most common living donors, but unrelated volunteers like Loritz can donate if they pass evaluation.
• Myth: being willing is enough. Many volunteers are turned down for medical reasons. Compatibility and the donor's safety come first.
• Myth: the donor is left with half a liver for life. The remaining liver regrows to near its original size within months.
• Fact: each story is individual. Brayden's excellent recovery is wonderful news, but outcomes vary, and a transplant team can only predict a particular patient's course after assessing them.

Brayden's sense of humour survived the ordeal: his chalkboard reads "Eww... I have girl germs", a joke about carrying a piece of his donor's liver.

Brayden's story is a reminder that the shortage of organs is a problem that ordinary people can help solve. Most of us will never be in Cami Loritz's position, but registering as a donor and talking about it with family makes it more likely that the next child on the list gets the call in time.

Sources: CBS 58 Milwaukee: Froedtert Hospital nurse donates liver to save 8-year-old boy (September 2019); WBAY: Wrightstown boy receives "miracle" gift (September 2019); The Brillion News: Life-saving gift unites nurse and boy (June 2019); Wikipedia: Living donor liver transplantation. Photos: the Auten family and Cami Loritz, as published in 2019 news coverage.