A Hollywood story: Daughter saved dad, then became a transplant doctor to save others

Dr. Hillary Yaffe, who years ago donated part of her liver to her father, now trains with the doctors who did the surgeries for her and her dad.
June 3rd, 2019

By Mark Couch and Todd Neff

Dr. Hillary Yaffe dances with her dad at her wedding. Dr. Yaffe donated part of her liver to save her dad's life.
Dr. Hillary Yaffe had always been close to her dad and stepped up to donate part of her liver to him. Then, came the exciting plot twists. Photo courtesy of Dr. Hillary Yaffe.

It sounds like a pitch for a Hallmark Channel Father’s Day movie: a Massachusetts dad is dying of liver disease. His daughter donates part of her liver to her dad, saving his life. The daughter goes on to be a doctor – not only a doctor, but also a surgeon, and not only a surgeon, but also a transplant surgeon. To become a transplant surgeon, one must complete a two-year fellowship on top of a five-year surgical residency. The daughter is now wrapping up the first year of that fellowship at the University of Colorado School of Medicine and UCHealth University of Colorado Hospital on the Anschutz Medical Campus.

Among her fellowship mentors are the very surgeons who operated on her and her father.

It really happened.

In 2008, Hillary Yaffe, a medical student with dreams of becoming a neurosurgeon, in fact provided a portion of her liver to be transplanted into her father, Alan Yaffe. His own was being ravaged by primary sclerosing cholangitis.

Dr. Hillary Yaffe, center, poses with transplant surgeons, Dr. Pomposelli and Dr. Pomfret
Hillary Yaffe first met Dr. James Pomposelli, left, and Dr. Elizabeth Pomfret, right, when she became her dad’s liver donor. Now, Yaffe is training with the doctors who did the transplant surgery for her and her dad. Photo courtesy of Dr. Hillary Yaffe.

Dr. Elizabeth Pomfret and Dr. James Pomposelli led the team that performed the surgeries. Now, a decade later and half a continent away, they are mentors to Dr. Hillary Yaffe, a surgeon midway through a fellowship. She will become a bona fide transplant surgeon in 2020.

“I think there have been different people who have had surgeries or might even have been donors and then went into medicine, but I don’t really know of another story like this,” Pomfret said.

Always close to her dad, oldest daughter stepped up as liver donor

This father-daughter story began in 2006. Alan, then 52, had been told years earlier that his liver was failing. The certified public accountant kept forging ahead professionally and at home. But was aware that he was, as he put it, “slowing down.” Work around the house in Worcester – mowing lawns, washing cars – that he had been able to wrap up in a day now dragged on through the weekend.

Alan, his wife and three daughters sat down for a meeting with the transplant team at the nearby Lahey Clinic. He needed a liver transplant, and a family member would be the best bet for a close match. Alan’s wife Sharon and middle daughter Rachel had the wrong blood types; his youngest daughter Dara had the same blood type but had diabetes, a disqualifier. Hillary looked like a match.

It was fitting, really.

“I’m the firstborn. We’ve been always been close,” she said. “I made him a father, and he’s taken that responsibility to heart as long as I can remember.”

Part of that responsibility had once involved trying to tire his young daughter out so she would finally go to sleep. One of his tactics was to play catch in the hallway, hiking and then throwing passes to the little insomniac using her favorite doll as an ersatz football.

Pomfret and Pomposelli were faculty at Tufts University School of Medicine and surgeons at the Lahey Clinic at the time.

“I remember her just sitting there and she was very confident that this was all going to work out and she was going to be a donor for her father and I thought, ‘Good for you,’” said Pomfret, who is now professor of surgery and chief of transplant surgery at the University of Colorado School of Medicine on the Anschutz Medical Campus.

Would she have a big enough liver?

Hillary came to meet Pomfret and Pomposelli in Boston because they were at the leading transplant center in the U.S. at the time. They specialize in living-donor transplants, which are critical for people who aren’t at the top of transplant lists.

It was clear Yaffe wanted to help her dad, but it wasn’t clear she could.

“She’s this teeny little thing and I remember her walking into my office and thinking there is no way this girl is going to have a liver big enough for her father,” Pomfret said.

Hillary Yaffe with her dad and their transplant surgeons, Dr. James Pomposelli and Dr. Elizabeth Pomfret.
Alan and Hillary Yaffe, center with their transplant surgeons, Dr. James Pomposelli, left, and Dr. Elizabeth Pomfret, right. Photo courtesy of Dr. Hillary Yaffe.

It’s not that Alan was a particularly large guy. It’s just that the donor needs to be big enough to donate a portion of liver that meets certain standards. Pomposelli said that a liver graft needs to be 1 percent of the recipient’s body weight.

“So if he weighed 155 pounds, then we’d like 1.55 pounds of liver,” Pomposelli said. “The question is, can your donor give that? It’s harder to go female to male for that reason.”

The liver-tissue standard was Hillary’s main worry, too.

“You either have it or you don’t. It’s not a matter of what your level of commitment is, how much you want to do this, how scared you are,” Hillary said. If you don’t have enough tissue, you can’t be a donor to that particular person.”

Hillary had enough liver to give, it turned out. She also passed third-party medical evaluations and psychiatric and social work checks that are required before making the donation. At the time, Hillary was in Philadelphia working on a master’s degree in medical science. On visits home, she found her dad layering two hoodies and wearing a hat indoors to keep warm and napping all the time.

“He just wasn’t himself,” she said. “It was clear he was sick. It was hard to watch.”

Without organ donations, 20% of those in need die

Then as now, about 20% of those who need a liver transplant die before they reach the top of the list. She didn’t want that for her father. Plus, she said, her dad was the family’s financial anchor.

“He’s the main provider and has been for decades,” Hillary said. “My family needed my dad and I found that there was a way to make that happen.”

She underwent the living donor workup over the course of a few months while she was working in Boston between her master’s program and medical school in Israel at the Sackler School of Medicine New York State/American Program at Tel Aviv University starting in the summer of 2007. She finished her first year and flew back home to start her summer break with a serious surgery to save her dad’s life.

She had no reservations and full confidence in Pomfret, who was to remove her liver, and in Pomposelli, who would transplant it into her father. And indeed, the July 23, 2008 procedures both went smoothly, though the immediate recovery was tougher on Hillary than her father.

“The hardest part about the surgery was her getting sicker when I was getting better at first,” Alan said.

She recovered quickly and was soon back in medical school. But the experience had changed her. She had decided years before – as a high school senior – that she wanted to become a physician and spent a year shadowing a neurosurgeon at the University of Massachusetts Medical Center in Worcester.

“I spent about the next 10 years wanting to be a neurosurgeon,” Hillary said. “During the first year of medical school, I did research in neurosurgery, I did research in neurology in grad school. And even a year after the transplant, I was still pursuing neurosurgery, which is what I thought my top interest was.”

The experience of being a living liver donor, though, prompted a reassessment.

An epiphany and a new calling – to help others with transplants

“I was back in the United States doing a follow-up appointment with Dr. Pomfret,” Hillary said, “and I was sitting in her office waiting for her to come in, on the exam table, thinking about life, and it just really hit me. I’m not supposed to be a neurosurgeon, I’m supposed to be a transplant surgeon.”

Her friends already knew. Calling her best friend from college, Hillary told her about the new career direction.

Dr. Hillary Yaffe
Dr. Hillary Yaffe donated part of her liver and saved her dad’s life. Then, she found her calling as a transplant surgeon. She’s now training at UCHealth University of Colorado Hospital. Photo courtesy of the University of Colorado School of Medicine.

“And she said, ‘We were waiting for you to realize that,’” Hillary recalled. “She said everyone had figured that out a year ago, and that they were waiting for when I was going to figure that out.”

When people asked Alan why Hillary made the switch, he tells them, “I have no idea,” and then laughs to make clear that he’s kidding.

Pomfret also remembered Hillary’s eureka moment.

“I remember she wanted to be a neurosurgeon,” Pomfret said. “And then all of the sudden, she said, ‘I’ve decided I’m going to do transplant surgery.’ And I said, ‘You know, you still have to complete five years of general surgery before you can do transplant surgery.’”

Hillary is now in the homestretch of that long run. Her dad, now 64, is healthy. He’s met grandchildren he would have never known. The family in general has a deeper sense of compassion, Hillary says, and is more keenly aware of life’s fragility.

At Hillary’s and husband Matthew’s wedding in 2010, she and Alan each chose a song for the father-daughter dance. They kept their respective selections secret.

She picked “Hello, Dolly” by Louis Armstrong, an allusion to those hallway football games way back when.

Her dad’s choice? Frank Sinatra’s “I’ve Got You Under My Skin.”

“There wasn’t a dry in eye in the house,” Alan said.

A version of this story first appeared on the University of Colorado School of Medicine’s website.