Tulane team performs life-saving liver transplant

One week, Sadie Smith was juggling college classes, long shifts at work, and a full social calendar. The next, the 20-year-old LSU student was in acute liver failure, facing the possibility of an emergency transplant.

What began as a typical flu-like illness quickly became something far more serious for Sadie. As many people do, she initially tried to push through feeling unwell. She had worked several long shifts in a row and assumed the aches and exhaustion were simply part of a busy schedule.

When her symptoms persisted for several days, Sadie visited a same-day clinic in Baton Rouge. She was evaluated and prescribed medication to treat what appeared to be a viral illness. When she went to the pharmacy, she learned the prescription couldn’t be filled until the following day.

That meant yet another night trying to manage the symptoms on her own.

Sadie turned to over-the-counter medication for relief from the fever and body aches.

“I very rarely got sick,” Sadie said. “So when I did get sick, I honestly freaked out a little and didn’t know what else to do other than take a bunch of Tylenol.”

Sadie had been taking extra-strength acetaminophen more frequently than recommended while trying to manage the symptoms. Over the next several days, her condition worsened. She developed persistent nausea, vomiting, and abdominal pain.

“It never crossed my mind that something you can buy over the counter could cause something so serious,” Sadie said.

As her condition continued to decline, Sadie’s mother, Christie Smith, drove to Baton Rouge to bring her daughter home to Covington. Concerned by how sick she appeared, Christie brought her to a local hospital for evaluation.

What doctors discovered there was alarming. Sadie was showing signs of acute liver failure.

Doctors determined that Sadie needed specialized care and arranged for her transfer to East Jefferson General Hospital (EJGH), the clinical home of Tulane University School of Medicine and the Tulane Transplant Institute. 

When the family arrived at EJGH, Christie immediately noticed the difference.

“We walked straight in, and they were ready,” she said. “It was fast but coordinated and calm; exactly what you want when you’re trying to take in everything that’s happening.”

One of the first physicians to evaluate Sadie was Dr. Giuseppe Morelli, Medical Director of Hepatology at East Jefferson General Hospital and Professor of Clinical Medicine at Tulane University School of Medicine, who helped assess her condition and begin coordinating her care.

As a teaching hospital, the Tulane team at EJGH includes physicians, residents, nurses, and staff working together to manage complex cases. For Christie, that team approach was immediately reassuring.

“There were people everywhere,” she said. “It was overwhelming, but in a good way. That’s what you want, a full team.”

When transplant surgeon Dr. Lee Cummings, Surgical Director of Liver Transplantation at East Jefferson General Hospital and an Associate Professor of Surgery at Tulane University School of Medicine, evaluated Sadie, the situation was already critical.

“She arrived in severe liver failure to the point of being mentally impaired,” Dr. Cummings explained. “The liver is responsible for clearing toxins produced by the body. When it stops working, those toxins build up and can affect brain function.”

Sadie was quickly evaluated and placed on the transplant list as a precautionary measure. Even so, the medical team hoped her liver might recover.

“Our goal is always to give the liver a chance to recover,” Dr. Cummings said. “Sometimes patients improve on their own, so we monitor closely while having a transplant available as a backup if recovery doesn’t occur.”

Over the next several days, doctors watched carefully for signs of improvement. Some laboratory values showed modest changes, but one critical factor remained unchanged.

“The primary concern was that she wasn’t waking up,” Dr. Cummings said. “Even though some of her lab numbers improved, her mental clarity did not. That told us her liver was not recovering.”

Then came the moment Christie had been dreading. Sadie needed a liver transplant.

A donor liver had become available, and the team needed to move quickly.

“They told me this was her chance,” Christie said. “As a parent, that’s a moment you never expect to face. But the doctors explained everything clearly, and I trusted them. I knew this was what she needed.”

Dr. Cummings described it as an excellent donor match.

“Sadie received a very good liver from a young, healthy donor,” he said. “For a young patient like her, that’s about as good as it gets.”

Dr. Cummings explained the transplant to Sadie’s family in terms they could easily understand.

“He told us he was giving her a Ferrari,” Christie said. “She had always wanted one, and well…she got one.”

The surgery was successful. When Dr. Cummings stepped out afterward to speak with the family, Christie remembers the moment clearly.

“He said everything went well,” she said. “That’s the moment when I could finally breathe.”

Sadie spent nearly three weeks recovering in the hospital before continuing her recovery at home.

“I had to force myself to do things that used to be easy,” she said. “But it’s gotten better.”

Christie also credits the entire care team for supporting Sadie through every stage of recovery.

“From the people who cleaned the room to the nurses, residents, doctors, and surgeons…everyone treated her with respect,” she said. “Those small things mattered.”

For Dr. Cummings, Sadie’s experience also highlights an important reminder about medication safety.

“We still see cases of accidental acetaminophen overdose in our community,” he said. “It’s a safe and effective medication when used properly, but people should always pay close attention to dosing instructions and avoid combining multiple medications that contain acetaminophen.”

Today, Sadie continues to recover and gradually return to normal life. During her health crisis, her mother created a Facebook page, “Slay Sadie Slay,” to share updates and help spread awareness.

This experience reinforced two important lessons for the Smith family: seek medical care when symptoms worsen, and recognize that advanced medical expertise may be closer than people realize.

The Tulane Transplant Institute at East Jefferson General Hospital provides advanced transplant and surgical services, supported by multidisciplinary teams backed by the power of academic medicine. 

“This case shows that we’re able to move quickly and provide high-level care when patients need it most,” Dr. Cummings said.

Read more about Sadie's story here.