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Cathy, Liver Transplant Recipient


Learn how Cathy was treated for cholangiocarcinoma with liver transplantation.


Basically, Cathy Dunnagan felt fine, getting up every day to manage her lawn-care business and raise her daughter, who was about to leave home for college. She had just one health complaint, an itch that was beginning to get the best of her. She was scratching her skin raw in places, and the itching kept her—and her husband—from sleeping. Though used to being healthy, Cathy finally went to see a doctor. Allergies seemed a likely culprit. Oatmeal baths were prescribed to soothe her skin and a sleep aid to get her through the night. But the itching persisted.

The next doctor Cathy saw referred her to a specialist for tests at Barnes-Jewish West County Hospital on Friday, July 30, 2008. And that’s where she was given the diagnosis of cholangiocarcinoma, a rare cancer affecting the liver’s bile duct. For Cathy, things were going to get worse before they got better, though she wasn’t aware of the path that stretched out in front of her. In fact, she says, “I really had no idea I was dying until I got better.”

Cathy was referred to William Chapman, MD, FACS, a Washington University surgeon and chief of the Abdominal Transplant Section at Barnes-Jewish Hospital. He told Cathy she needed a liver transplant; the location of the cancer made surgical removal impossible. “I asked Dr. Chapman if I’d be able to see my daughter graduate from college. He said ‘Yes.’”

The kind of liver transplant and treatment Cathy needed was only being done in clinical trials at two hospitals, which meant she had two options: receive care at Barnes-Jewish or travel to the Mayo Clinic. “Barnes-Jewish was just 25 minutes from my front door,” says Cathy. She made her decision.

The first part of treatment included weeks of chemotherapy and radiation to help keep the cancer from affecting other organs. “Afterward, Cathy had a limited surgery to make sure the cancer hadn’t spread,” says Dr. Chapman. “She was on a waiting list for a donor liver for about six months.”

The transplant took place on May 24, 2009, and was followed by an 11-day hospital stay, longer than usual because one of Cathy’s lungs collapsed. She was finally released to home and family, but on July 1, problems arose and she returned to Barnes-Jewish. Dr. Chapman says Cathy experienced a rare transplant complication that required him to remove the organ he had placed just a few weeks earlier. “We had 24 hours to find a new liver,” Dr. Chapman says. Cathy was unaware, though her husband says he was confident his wife was in good hands.

After the second transplant, Cathy needed a good deal of time to heal. And she has. Dr. Chapman says, “Cathy’s prognosis is excellent. The further out she is from transplant, the lower the risk for a recurrence of cancer.”

Cathy says, “Dr. Chapman and Barnes-Jewish saved my life. Because they were close to home, I didn’t have to run around finding doctors. I didn’t have to Google everything, looking for hope. I was given hope from the minute I was diagnosed.” And that college graduation? Dr. Chapman was right; Cathy was there.

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