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St.

Albert Gazette
Gift of a lifetime; The life of a young girl lives on in the body of Adam
Fortier and in the spirit of his mother Jan
Sat Jun 2 2007
Page: 17 / FRONT
Section: Scene
Byline: Peter Boer
Source: The Gazette
Illustrations: Photo: Lyle Aspinall, St. Albert Gazette / ALWAYS SMILING: Rick and Jan Fortier of St. Albert
share a happy moment with their 23-year-old son Adam. After undergoing a liver transplant in 1989, Adam
suffered a series of strokes that left him brain-damaged. Jan is now a nurse and works with transplant patients.
Photo: Peter Boer, St. Albert Gazette / ALWAYS HOPE: Karen Olivier works as an organ donor co-ordinator with
the Human Organ Procurement and Exchange (HOPE) program.
Photo: NEW ORGAN: Adam Fortier on Jan. 28, 1989, three days after receiving his donated liver.

A little over 18 years ago, a five-year-old


girl died after she was struck by a
snowmobile while attending a winter
carnival with her grandfather. Her death
gave Adam Fortier another shot at life.
Adam's parents Jan and Rick don't know
much else about the girl who gave up her
liver for their son. They know doctors were
also able to transplant her heart and
kidneys to other recipients.
"That's all we're entitled to know about her
and it's more than I really wanted to know,"
says Jan. "But it helps to understand the
feelings the family had at the time, to know
their five-year-old allowed our
five-year-old another chance is very
special."
Today Adam is a robust young man, who
loves swimming, riding horses and
watching movies. He has an uncanny knack
for memorizing song lyrics and can recite
every single word from his favourite movie
Top Gun.
In 1989 Adam's future looked bleak. He
was diagnosed at the age of two with a
blood disorder known as Langerhan's cell
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hystiocytosis, an extremely rare condition


in which the body produces too many
macrophage cells or "garbage men," as Jan
calls them, responsible for destroying
harmful proteins. When there are too many,
those macrophage cells start destroying
healthy cells. By the time Adam was four,
the disorder, coupled with the aggressive
chemotherapy he had received to treat it,
caused his liver to fail, necessitating a
transplant. After a two-and-a-half month
wait, the Fortiers got a phone call that a
liver was available.
"We were living in Winnipeg at the time,"
says Jan. "We got our phone call at 7 p.m.,
and by 10 p.m. that night I had been home,
packed, gone to the bank for money, said
goodbye to the kids and kissed my husband
goodbye."
Adam's chief concern, Jan remembers, was
when he would get to eat breakfast.
"They told him it would be three or four
days, but the look on his face 'you're
kidding! But I'm going to be so hungry!' "
After a six-hour surgical procedure, Adam
was released to the intensive care unit and
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six days later he was transferred to the


pediatric floor. Despite some initial
concern about rejection, Adam adapted to
his new liver remarkably well.
But six weeks later, Adam suffered a series
of strokes that left him brain damaged.
"He was watching cartoons, then he had a
nap and then he didn't wake up," Jan
recalls.
Adam suffered brain damage as a result of
the stroke. He is partially paralyzed on the
right side of his body and he doesn't speak
much, but he smiles almost constantly.
He is also Jan's inspiration. As a result of
Adam's experience, Jan went back to
school, became a nurse and now works
with transplant recipients and donors at the
Stollery Children's Hospital at the
University of Alberta.
"I was exposed to so many excellent role
models. I don't know if I'll ever be an organ
donor, but I can certainly give of myself in
other ways."
Constant care
The procedure of donating and
transplanting an organ is not an event, says
St. Albert resident Karen Olivier, so much
as a process.
Olivier works as an organ donor
co-ordinator with Capital Health's Human
Organ Procurement and Exchange (HOPE)
program. She is responsible for arranging
the transplant process.
"We're not there to try and talk people into
doing something they don't want to do,"
says Olivier. "Virtually all of the time

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when we are invited to talk to a family it's


because they have an idea at least that it's
something they may be interested in."
Jan and Olivier are integral parts of the
donation and transplant process. The
process typically begins when a patient
suffers some sort of brain trauma, whether
from a car accident or a stroke. If that
trauma leads to brain death, which is
certified by a doctor not associated with a
transplant team, Olivier approaches the
family of the victim and asks if they would
like to donate the victim's organs.
"If that's something they feel comfortable
with, the process would go forward and the
donation would occur," she explains.
Once the family gives consent, the rest of
the process can follow very quickly.
Physicians type the prospective organs by
the height, weight and blood type of the
donor and match the results with potential
recipients. The organ has to be in good
condition, must benefit the recipient and it
has to fit.
"It's simple physics," says Olivier. "You
can't put the lungs of a 90-kg male into the
body of a 45-kg female."
The victim still continues to receive a high
level of care, even after they have been
certified as brain dead. Jan says she will
talk to donors as she moves them in their
beds. She will wipe dried saliva from their
lips and dirt from the corners of their eyes,
even though it might not seem to matter.
"It's important to the family," says Jan.
"They need to see that their family member
is still being cared for as an important
person, as someone who has loved and will
still be loved forever and one way we can

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do that is to carry on as if nothing has


changed."
When the surgical team is ready, the family
can walk with the donor's gurney right up
to the doors of the operating room. Some
families will even visit with the donor after
the organs have been removed.
Olivier explains doctors are careful to
avoid any excess scarring or trauma to the
body during the operation.
"No one wants their loved one to be
mistreated or if you like, in any way
severely scarred. They are closed correctly
as any other incision."
GROWING DEMAND
"An organ transplant is not a cure," says
Jan. "It's exchanging a life-threatening
illness for a chronic one. You are tied to
the medical field for the rest of your life."
Even though he is 18 years removed from
his transplant, Adam still requires constant
blood work to check the condition of his
liver. He takes immunosuppressant drugs
that prevent his body from rejecting the
liver. Those drugs have side effects of their
own. Adam, 23, takes blood pressure
medication because of his anti-rejection
drugs and calcium supplements to battle
the risk of osteoporosis.
Medical technology has improved
markedly since transplants became
feasible. Doctors can now transplant
kidneys and partial livers from live donors
to recipients. They can also perform 'ABO
incompatible' heart transplants, in which
the donor heart's blood type does not match
the blood type of the recipient.

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And yet, says Olivier, there is still a


chronic shortage of organs. There are
approximately 350 people in the Capital
Health Authority region alone every year
who need an organ transplant. In 2006, 32
people waiting for a vital organ died.
"We will never have enough donors to give
everyone an organ who needs one. You're
much more likely to require an organ or
tissue transplant than you are to ever
become a donor."
Jan and Olivier agree it isn't easy to ask a
family, contemplating the death of a loved
one, to decide whether or not to allow the
victim's organs to be removed. Olivier says
many of those concerns could be addressed
if people signed their donor cards and
discussed the issue with their next of kin.
"It's a terrible thing to have to face and
decide in the middle of that grief-stricken,
shocked, angry situation. When it's talked
about, it makes it so much easier for them,"
says Olivier.
It might be difficult to see at the time, but
making that one decision can affect more
than just one person, says Jan. When that
little girl died, it wasn't just Adam who got
a new liver. Someone else got a new heart
and someone else new kidneys. The
experience also inspired Jan herself to
dedicate her life to helping kids in need of
organ transplants.
"The people who can see past this moment
and look down the road and say, "This is a
horrible thing for us but maybe we can
make things better for someone else,' that is
a huge gift," says Jan as she watches her
son. "The people who can do that when
they are experiencing the most horrendous
experience of their lives are heroes to me.

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Total heroes."

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