Sister becomes living donor for ailing brother
Courtesy of Jill Esken
Courtesy of Jill Esken
David Esken, left, is reunited with his sister, Kathy Martino, right, the day after Martino donated a portion of her liver to Esken. Esken had been diagnosed with cancer in June 2022, which resulted in him needing a liver transplant.
Courtesy of Jill Esken
Courtesy of Jill Esken
David Esken of Finleyville successfully underwent liver transplant surgery on Feb. 13 in UPMC Montefiore Hospital. Esken’s sister, Kathy Martino, volunteered to be a living donor for him.
Photos: Courtesy of Jill Esken
David Esken of Finleyville is shown with his sister, Kathy Martino, at UPMC Montefiore Hospital, after David received a liver transplant from her. Martino volunteered to be a living donor for her brother.
David Esken of Finleyville has always been close with his four siblings.
He talks with his twin brother, Donald, his other brothers, and his sister every day, and the five often get together.
So it was no surprise that when Esken, 57, was diagnosed for a second time with colon cancer in June 2022 and ultimately ended up needing a new liver, his sister, Kathy Martino, didn’t hesitate to donate a portion of hers.
“I don’t think there was ever a question. It’s your brother. If there’s anything you can do, you do it,” said Martino, 55, of Jefferson Hills.
On Feb. 13, doctors at UPMC Montefiore performed the life-saving liver transplant, removing Esken’s liver and replacing it with a portion of Martino’s.
Esken said he was grateful his sister was willing to become a living donor to help save his life.
“Absolutely life-changing. It’s the biggest gift that anybody could ever give someone,” said Esken on Friday, while recuperating at Montefiore.
Esken’s ordeal began 3 1/2 years ago, when he was diagnosed with colon cancer and underwent surgery to remove the tumor.
But in June 2022, a routine CAT scan at the UPMC Hillman Cancer Center showed two tumors on his liver. The cancer had returned.
“It was devastating,” said Esken’s wife, Jill Esken. “He was religious about going for all of his tests and scans and doing everything he was supposed to do. We were devastated.”
In August, Esken began three months of chemotherapy, and on Dec. 20, doctors at UPMC Montefiore performed resection surgery, where they removed 55% of his liver.
What makes resection possible is the liver’s natural ability to regenerate; the liver is the only organ in the body that can replace lost or injured tissue. Surgeons can remove up to 80% of the liver and it will grow back in a matter of weeks, if the remaining liver is healthy.
But in Esken’s case, the liver did not regenerate.
“No matter what, the liver was just not regenerating, and his health was failing fast,” said Jill Esken.
Esken remained hospitalized through Christmas and New Year’s Day, and finally returned home in mid-January, but he was rushed back to the ICU at UPMC a couple of days later, after blood tests showed his kidneys were faltering.
Doctors told Esken, who by then was critically ill, his best chance for survival was to be placed on the organ transplant list. His insurance company approved Esken to receive a liver from either a deceased or a living donor.
Initially, Donald volunteered to undergo testing to see if he was a match.
But when a deficiency was found in Donald and he was ruled out as a donor, Martino came to her big brother’s rescue.
Following two days of testing, Martino found out on Feb. 10 that she was suitable to donate her liver.
But an emotional Esken was worried about his siblings serving as a donor.
“He said many times that if something happened because a sibling donated, he wouldn’t be able to live with that,” recalled Jill Esken. “We were new to the whole process, but the more we found out about it, the better he felt.”
Martino, for her part, was determined to do whatever she could to help her brother.
“My brother is always the happy, fun-loving life of the party, and I couldn’t see not having that at our family (get-togethers),” said Martino. “It was not his time. Not that way.”
As the day of the surgery drew near, Martino’s concern for her brother grew. He was lethargic and swollen from retaining fluids, his complexion was yellow, he had lost his appetite and vomited, and at times he was not lucid. His bilirubin count, which shouldn’t exceed 1.5, had soared to 42.
“As a family, we were all very eager for that day to get there. He was struggling, and I knew it was getting bad,” said Martino. “I was worried he wasn’t going to make it.”
For the family, the date of the surgery was bittersweet: five years ago, on Feb. 13, the siblings’ mother passed away. Half a decade later, Esken was getting a second chance at life.
On the morning of the surgery, Martino was wheeled into Esken’s room, and the two chatted briefly before they headed to the operating rooms.
The pair did not see each other until the next morning, but Esken’s nurses popped into Martino’s hospital room frequently to provide updates.
“The nurses were so great. I was so worried about him, but they kept filling me in. The next morning, they took me to his room, and he looked great,” said Martino. “He made it through. It was a relief.”
A few days after the transplant, Martino, who works at Allegheny Health Network Jefferson Hospital, was released from the hospital and is recovering at home.
Martino, who donates blood regularly and is a registered organ donor on her driver’s license, was not aware that living donors could donate until her brother’s health crisis.
Now, she and her family are advocates for altruistic living organ donation.
“I would never have known you could be a living donor if I had not been placed into this situation with my family. I plan on being an advocate for donation. If you can, do it,” said Martino.
According to the Center for Organ Recovery & Education (CORE), there were 314 living donors in Pennsylvania in 2022, the fifth highest number of living donors since the Organ Procurement and Transplantation Network began tracking numbers in 1988. Of those, 269 were living kidney donors and 45 were living liver donors.
Of the 6,465 living donors in the United States in 2022, 838 were siblings of the recipient, and 11 were the identical twin of a recipient.
“Living donors can play a powerful role in reducing the wait time for someone on the waiting list for a life-saving transplant. It’s an incredible gift of a second chance and it’s possible for many people to do,” said Katelynn Metz, spokesperson for CORE.
Esken, who describes himself as “a nonstop guy” before his his bout with cancer, is eager to resume his life.
One week before Esken received his most recent cancer diagnosis, he had begun a new job – he helped launch a company – and is ready to get back to work.
He is expected to be released within the next few days, and thanked doctors and staff at Montefiore whose care, he said, made it possible for him to “go through hell in heaven.”
“I feel better every day,” said Esken. “Every day is like a new day.”