Emergency liver transplant at age 20: How East Jefferson General Hospital gave Sadie a second chance

When Sadie Smith was 20 years old, life was moving fast. She was a student at LSU. She worked as a bartender and loved going to football games and lifting weights. She came from a tight-knit family with her mom, Christie, her dad, and 16-year-old twin sisters. They were “go go go” people, Christie said. Vacations. Boating. Always together.

Then Sadie got the flu. Within days, what seemed like a routine illness turned into acute liver failure.

Sadie underwent a series of hospital transfers before arriving at East Jefferson General Hospital, part of LCMC Health, where the Tulane Transplant Institute performed the emergency liver transplant that saved her life.

Today, Sadie is rebuilding her life with a new liver, a new perspective, and a deep appreciation for the expert transplant team at East Jefferson General Hospital.

A sudden spiral and the path to specialized liver care

It started on a Monday. Sadie was trying to manage her flu symptoms so she could return to work.

“I was taking Tylenol almost every hour because I just wanted to feel better quickly,” Sadie recalled. “I didn’t realize how dangerous it could be.”

Tylenol contains acetaminophen, a common over-the-counter medication that in high doses can overwhelm the liver.

At first, there were no obvious signs of how serious it would become. At a local emergency room, Sadie’s lab results did not immediately indicate liver failure, and she was treated for possible acetaminophen toxicity. At the time, there was still a sense that her symptoms might be due to dehydration or lingering effects of the flu.

Still, something did not sit right with Christie, who had been in close contact with her daughter throughout those initial hours. She drove to Baton Rouge to bring Sadie home to Mandeville, trusting what she later described as a mother’s intuition. Not long after, Sadie began vomiting repeatedly and returned to the emergency room as her symptoms worsened.

Overnight, Sadie’s condition declined. Her liver enzymes rose sharply and her kidneys began to struggle. As the severity of her illness became clearer, she was transferred to East Jefferson General Hospital in Metairie for an advanced hepatology evaluation and transplant management.

For families across Louisiana, having a transplant institute within reach means specialized liver care is available close to home. In cases of acute liver failure, timing is critical. At East Jefferson General Hospital, the dedicated transplant team was ready to take over.

From acute liver failure to life-saving transplant surgery

When Sadie arrived at East Jefferson General Hospital, Giuseppe Morelli, MD, evaluated her immediately. A gastroenterologist and liver transplant expert, Dr. Morelli serves as Medical Director of Hepatology at East Jefferson General Hospital and is also a Professor of Clinical Medicine at Tulane University School of Medicine.

He asked her a simple question: “Where are you?”

Christie remembers her daughter answering, “Purple.”

That response confirmed what her lab results were beginning to show. Her liver was failing rapidly and the buildup of toxins was affecting her brain function.

“Acute liver failure is one of the most urgent conditions we treat,” said Dr. Morelli. “The liver supports hundreds of critical functions in the body. When it stops working, the situation can escalate quickly and affect multiple organs. Sadie required dialysis as her kidneys began to struggle.”

Within days, it became clear that her liver was not recovering.

In cases of sudden, severe liver failure, the transplant evaluation and listing must move quickly. The care team began the formal process to place Sadie on the national liver transplant waiting list.

Her lab values continued to worsen, and imaging confirmed there were no meaningful signs of regeneration. As neurologic symptoms progressed, the medical team prepared the family for the reality that transplantation had become the only viable option.

“You don’t want your child to need a transplant,” Christie said. “But the team was steady and honest with us. They explained exactly what was happening and reassured us every step of the way. We trusted them.”

Soon after, a donor liver became available from a young, tall, healthy individual. Although slightly larger than Sadie’s original liver, it was still an excellent size match, offering reassurance that the organ was strong and healthy.

On November 25, 2025, Lee S. Cummings, MD, Surgical Director of Liver Transplantation at East Jefferson General Hospital and an Associate Professor of Surgery at Tulane University School of Medicine, performed Sadie’s liver transplant.

This life-saving transplant was the result of a highly coordinated, multidisciplinary effort involving hepatology, transplant surgery, critical care, anesthesia, nursing, and transplant coordination teams. From the moment Sadie arrived, specialists across disciplines worked in close collaboration—rapidly assessing her condition, managing potential multi-organ complications, and guiding her through evaluation, surgery, and recovery. This level of coordination is essential in cases of acute liver failure, where timing, communication, and expertise across teams directly impact outcomes.

The surgery lasted approximately six hours. Throughout the procedure, the family received structured updates at key milestones, including when her diseased liver was removed and when blood flow was restored to the new organ.

“During a liver transplant, we remove the failing liver and carefully connect the donor organ to the body’s major blood vessels and bile ducts,” Dr. Cummings said. “Restoring circulation is a critical moment. From there, our focus shifts to protecting the organ and monitoring recovery. In Sadie’s case, we tracked her liver function carefully to ensure it was working as expected.”

Pathology later confirmed the urgency of the decision. Sadie’s original liver showed no meaningful signs of recovery. Without transplant, she likely would not have survived.

Today, the family carries deep gratitude for the donor and the donor’s family. In the midst of their relief, they recognize that another family made an extraordinary decision that made Sadie’s second chance possible.

“I’m so grateful to the donor and their family,” Sadie said. “Because of them, I get to keep living my life.”

Recovery and life after a liver transplant

Because of the severity of her case, Sadie remained hospitalized for nearly three weeks, including time before and after surgery.

The transplant team monitored her closely for bleeding, infection, and rejection. When labs raised concern, a biopsy was performed. Her medications were adjusted quickly, and the results were positive.

She began physical therapy in the hospital and remembers being one of the youngest patients on a unit largely made up of older adults. In the first couple of days after surgery, she was confused and disoriented, something that can happen after a major procedure. Gradually, her thinking became clear again.

Sadie received detailed guidance on lifelong immunosuppressant medications, signs of rejection, infection prevention, and lab monitoring. The team also provided detailed discharge education, written materials, and 24/7 nurse coordinator access to support patients long after they leave the hospital.

Months later, Sadie has regular bloodwork, attends scheduled clinic visits, and takes her medications twice a day without fail.

“I never miss a dose,” Sadie said. “I show up for every lab. It gave me a new level of focus and appreciation for my health.”

Her immune system is permanently suppressed, so she monitors her diet carefully, avoids high-risk exposures, and understands that long-term transplant care requires ongoing vigilance. Like all transplant recipients, she knows transplanted organs do not last forever. For now, she is focused on living fully.

For Christie, what stands out most is not only the surgery itself, but the continuity of care that followed.

“They saved her life,” she said. “But they also walked us through every step after so we could feel more comfortable moving forward. If another family is facing something like this, I would tell them to find a team you trust, ask questions, and lean on their expertise. We always felt supported.”

For families facing acute liver failure or advanced liver disease, access to specialized transplant care close to home can make all the difference. To learn more about liver transplant services at East Jefferson General Hospital, visit EJGH.org/Transplant.