Retired URI Prof. David Gitlitz, left, needed a liver transplant. Daniel Carpenter, of Wakefield, right, who teaches Latin, Greek and classical civilization courses at URI, became the donor.

The Providence Journal / Gretchen Ertl

SOUTH KINGSTOWN — David Gitlitz didn’t think very often about the miracle of organ transplants — until it became clear that he might need a miracle himself.

A professor of languages at the University of Rhode Island, Gitlitz has traveled the world, written books and scholarly articles, and lives in a circa-1750 Kingston house with his equally accomplished wife, Linda. He led a busy life, uncomplicated by alarming health forecasts, until a decade ago.

That was when he began to find himself short of breath. He blamed it on age. Then a persistent stomachache turned into an emergency appendectomy.

While operating, Gitlitz’s surgeon, Dr. Umberto Capuano of Narragansett, “took a peek and said he didn’t like the color of my liver,” Gitlitz recalls.

“A healthy liver looks purple,” Capuano says. “His did not look that way.”

Though Gitlitz had lived a half-century with few symptoms other than a low tolerance for alcohol, he was soon diagnosed as Alpha-1 antitrypsin deficient — an inherited disorder that assaults the lungs and liver. And when the liver is damaged, fluids accumulate, toxins build up and there’s a danger of blood clotting.

Last fall, Gitlitz “ballooned up,” he recalls, gaining weight as a result of his condition. The symptoms he had been warned about intensified: shortness of breath, weight fluctuation and fatigue. It became clear, he says, “that I would get much sicker, and could die.”

The word went out quietly that Gitlitz needed help. He needed a liver transplant.

Seven relatives and friends offered a piece of theirs.

Three of the possible donors were relatives — Gitlitz’s daughters, Abigail and Deborah, and his brother, John. The others were two friends of two decades’ standing, David and Susan Offer, of Maine; a colleague, Daniel Carpenter, of Wakefield; and a friend of Abigail’s, Richard Willey, of Natick, Mass.

“If my liver equals Dad’s life, well, what other choice is there?” reasoned Deborah, 38, a youth librarian and storyteller.

Equally minimalist was the mindset of David Offer, former editor of The Newport Daily News, and his wife, a former nurse.

“It’s really simple,” David Offer says in an e-mail. “David [Gitlitz] is a very good friend. We knew that the liver transplant was needed to save his life. So we volunteered.”

But Abby Gitlitz, a 35-year-old graduate student living in Illinois, had trouble understanding her friend Richard’s motivation.

“I offered my liver to my dad because he is my dad,” Abby says. But why would Richard make the same offer? “I tried really hard, really hard, even knowing that I would be the next possible donor, to talk him out of it,” she says of the man she has known for almost 20 years and she describes as being her best friend. “He seemed offended and a little mystified.”

“I’ve known David and his family for almost 20 years,” Willey explains. “The main reason that I offered to be a donor was that the alternative was too ugly to contemplate. If David didn’t get a new liver, he would spend several very painful months getting progressively sicker, and then die.

“I couldn’t live with myself if I didn’t try to do something.”

BUT NOT EVERY potential liver donor is the right match. Donors have to be healthy, and under the age of 60. Liver regeneration is slower after age 60, said Dr. Elizabeth Pomfret, director of live-donor liver transplantation at the Lahey Clinic in Burlington, Mass. And they must have compatible blood types, similar body mass and similar placement of arteries, ducts and veins.

“We reject approximately 40 percent of the donors for a variety of reasons that include anatomic, medical or psychological problems,” says Dr. James J. Pomposelli, a surgeon at the Lahey Clinic Medical Center, in Burlington, Mass., where Gitlitz was being treated.

David Offer was eliminated because of his age, 66. Susan Offer, who is 58, and Gitlitz’s daughters went through screening, but one by one they were dropped from the list. His brother John, of Mamaroneck, N.Y., also a college professor, was eliminated because he has diabetes. Only Carpenter, 45, and Willey, 41, remained.

But both of them were eliminated, too, because of their weight, which caused their livers to be too fatty to use. A usable liver should have no more than 10 percent fat. Carpenter’s had more than three times that much.

Meanwhile, Gitlitz was getting sicker.

“It hurt to watch him suffer and be unable to do so many things he loves to do: Hike, write, play guitar, travel,” Deborah says. She wondered, “Would he get a new liver in time — in time to save his life?”

DONATING A PIECE of your liver is not risk free. According to Dr. Pomfret, most donors have no problems during surgery. And while the operation takes 60 percent of the donor’s liver, it regenerates itself “like a salamander’s tail,” Gitlitz says, leaving no permanent damage.

Still, complications can arise during surgery, such as a blood clot or pneumonia. And, Gitlitz notes, “there is some risk of dying on the table.”

Willey and Carpenter both researched the risks, and yet they still wanted to be donors. They both started dieting and exercising.

“David has been a mentor to me, and a close friend,” Carpenter says in explanation.

Carpenter added exercise to his lifestyle, which centers on classrooms in URI’s Department of Languages where he is a lecturer. He gave up beer and, a personal favorite, popcorn.

He kept working at the diet and in February asked the clinic to re-biopsy his liver. The test showed that his liver fat had come down from 32 percent to the 10-percent target.

He was now the perfect candidate.

“THE OPERATION is very long and complicated,” says Gitlitz. Only 300, in fact, are performed in the United States each year.

On March 5, starting at 7 a.m., Dr. Pomfret removed 60 percent of Carpenter’s healthy liver. As the day progressed, Gitlitz’s diseased liver was removed, and Dr. Pomposelli conducted the replacement. The whole process took almost seven hours.

The doctors are used to working as a team. Pomposelli is Pomfret’s husband — they met in high school in New Jersey, went to different colleges, and then were both admitted to Boston University School of Medicine. Pomposelli is, coincidentally, a 1982 graduate of URI, where he majored in zoology, but the college connection to his patient never came up before the operation.

In the waiting room, Carpenter’s wife, Jean, and Gitlitz’s wife, Linda Davidson, comforted each other, some of the time with Jean’s piano music.

“There’s a baby grand at Lahey,” says Davidson. “We hung out and helped each other.”

Gitlitz and Davidson, a URI language instructor, had shared more than the personal side of a 20-plus-year relationship. They had traveled the world conducting academic research. In 1999, they wrote and published A Drizzle of Honey: The Lives and Recipes of Spain’s Secret Jews, which won a Jewish Book Council National Jewish Book, as well as the International Association of Culinary Professionals’ Jane Grigson Award for Distinguished Scholarship.

“The surgery aspect didn’t really bother me,” Davidson says now. It was the process of finding a donor that tested her strength — “and the prospect of seeing him degenerate really scared me.”

IN THE HOURS after the operation, daughters Abby and Deborah arrived to give Davidson breaks to return home, feed the cats, and recoup energy.

“ ‘He looks really bad,’ ” Abby recalls her mother saying when she arrived at the hospital. “ ‘Yellow and badly bruised all over and gaunt. He has tubes sticking out all over, and he is weak.’ ”

It took Gitlitz two days to become conscious after the operation, he says. “Waking up was a long and difficult process.”

A month after the surgery, thin but not frail, Gitlitz moves cautiously but not slowly. His emotions are not hidden. He’s clearly warmed to see Daniel Carpenter arrive at his doorstep, and they joke about sharing body parts.

It will take about a year for Carpenter’s liver to regenerate fully. Other than feeling tired, he says he’s not feeling uncomfortable. He talks reluctantly about his contribution.

“There was really very little pain.” He’s happy, too, that he now is 25 pounds lighter. “I’m going to try to keep it off.

“Looking back, it was a really good experience, and I was just happy to have the opportunity to help him out. It felt like a real good thing.”

There’s no telling how long it will take Gitlitz, his wife and daughters to recover from the emotional ski run they’ve experienced during the past year.

In a letter to family and friends, Gitlitz wrote that he is still feeling “shock and gratitude that seven different people took it on themselves to offer me half of their livers. … Just the thought of it, and I think of it often, makes me have to step away (as I have done for five minutes between the last sentence and this one), wash my glasses, and pull myself back together.”

I’M STILL IN complete awe,” Gitlitz says. And despite all the pain, worry and effort, he and Davidson call the whole process “a wonderful experience.”

Their daughters share similar sentiments.

“I’m not recommending that people go and have their parents hacked open,” says Abby, “but that time together was one of the most meaningful moments I have ever had with my dad.”

Deborah says, “We have all been broken open by this experience, and our guts are a little bit more out in the open.”

Gitlitz, 66, recently retired. He said he hopes to return to teaching on some level in the fall, to continue his research, perhaps spend winters in Florida.

But right now, Kingston is blooming with spring flowers. Commencement at the university is less than a month away.

For David Gitlitz — with his shiny new liver, as he calls it — the winter of his pain and dismay is past.

He accepts that seven people stepped forward to sacrifice their bodies for him.

“The best I can do is ascribe it to altruism, their unselfish commitment to my welfare,” he writes in a post-hospital composition.

“By me, they are all of them heroes.”What is AAT?

   According to the U.S. Department of Health and Human Services, Alpha-1 Antitrypsin Deficiency, or AAT, is an inherited condition. Some people develop severe emphysema, making it hard to breathe, while others develop serious liver diseases.

   Alpha-1 antitrypsin is a protein made in the liver. The protein goes into the bloodstream, protecting the body’s organs, especially the lungs.

   When a deficiency occurs, proteins made in the liver aren’t the right shape. They get stuck and can’t get into the bloodstream. “Because not enough AAT protein travels to the lungs to protect them, the risk of lung disease increases. Also, because too many AAT proteins are stuck in the liver, liver disease can develop.”

   Estimates of how many people have the condition range from about 1 in every 1,600 people to about 1 in every 5,000 people. In the United States, white people of western and northern European descent are more likely than other ethnic groups to have AAT.

   For more information, go to the Web site of the nonprofit Alpha-1 Association, www.alpha1.org

afleming@projo.com