Six degrees of separation: Organ recipient believes god answers prayers

In every practical sense, this living organ donor and recipient were strangers. Now, the recipient says their connection is one of several answered prayers in her life.

By IU Health Senior Journalist, TJ Banes, tfender1@iuhealth.org

She thought it might be a female. Amanda Bilger had no idea who was her living liver donor. She couldn’t imagine someone offering up an organ to a stranger.

“It’s such a major surgery and a lot of men are the breadwinners so I couldn’t imagine very many men being able to take off that much time from work,” said Bilger. As time went on, she began to change her suspicions. Bilger attended an event raising awareness for organ donation where she was introduced as a living donor recipient. A family member of the donor heard Bilger mentioned and put two and two together. The event was two months after the transplant.

Just less than a year after Bilger’s liver transplant, her suspicions were confirmed when she came face-to-face with Bret Schmutte, the man who was an altruistic organ donor. At the request of both recipient and donor, the two were introduced.

Today, on National Donor Day, Bilger shares the story of meeting the man who gave her the gift of life.

Within minutes of meeting, Bilger and Schmutte realized they are both from Noblesville; they share the same March birthdays - just one day part. And now they celebrate their one year of liver transplantation on March 7.

It was late summer of 2007 when Bilger was diagnosed with Primary sclerosing cholangitis (PSC), an inflammation that causes scars in the bile ducts. She was 30. Over time, the scarring resulted in liver damage.

“I had a lot of skin problems that couldn’t be explained by anything and then I had bloodwork and it showed my liver enzymes were super high,” said Bilger, who grew up in Frankfort and worked as a professional photographer. She had just celebrated her first year of marriage to her husband, Zach Bilger and they were ready to start a family. As her condition progressed, specialists suggested pregnancy could be risky and possibly cause her disease to advance more quickly.

On the day she shares her story, Bilger wears a bright green vest - the color for organ donation. She also wears a silver wishbone charm around her neck. The charm is engraved on the back, “our little miracle.”

When Bilger and her husband realized the risk of her carrying a child, they began a search for a surrogate. They are now the parents of two daughters - both biological embryos - delivered by the same gestational carrier. Their youngest is 8; their oldest is 12.

As her disease progressed, Bilger said she grew so thin her bones were visible, she was swollen and jaundiced.

“I wanted my girls to have memories with me, but I started to notice how different I was looking in pictures with them. My. eyes were a scary yellow, and my skin didn’t match theirs anymore and it made me sad. I also didn’t want them to see me get any sicker,” said Bilger, who was in the care of IU Health’s Dr. Marwan Ghabril. By January 2022, she was listed for transplant.

Little did she know, a man living in the same town was researching his own plan to become a living donor. Schmutte grew up in Fishers, Ind. graduated from Cathedral High School and received his bachelor’s degree in accounting with a minor in computer science from Marian University.

He married his wife, Nora, 28 years ago and together they have three children.

“My mom is a nurse and growing up I always saw her helping people. She was definitely a role model to me and my four siblings,” said Schmutte. Later in life, when he was living in a rural area of Colorado and learned of a need for medical volunteers, he received his EMT certification.

“I knew about the concept of being a living organ donor but I didn’t give it much thought when my kids were younger because I thought about them and their needs,” said Schmutte. Later, he decided to go through testing to become a living liver donor. He didn’t know who would be his recipient; he just knew someone needed his liver.

At IU Health many recipients receive kidney and liver transplants from living donors.

Last year, IU Health performed 160 liver transplants. Donate Life America reports there are 14,000 people in the United States on the waiting list at any given time for a liver transplant. The number of patients waiting far surpasses the number of deceased donors. Many patients spend years waiting for a liver donor. Living donors reduce that wait time. An organ from a living donor can function better and last longer than one from a deceased donor because it is coming from a healthy, living donor. Like kidney donation, liver donation is done by working with a team of IU Health transplant experts including surgeons, donor coordinators, social workers, dietitians, pharmacists, and financial coordinators.

Living donors undergo an initial screening, multiple tests and evaluations. The transplant involves removing a portion of the donor’s liver and then using it to replace the diseased liver in the recipient. The liver regenerates and returns to full function within a month. Both kidney and liver donors are typically discharged from the hospital within a few days.

“I consider myself very healthy. It was certainly a difficult surgery, but I feel like I recovered quickly and quite well,” said Schmutte. He and Bilger were both in the surgical care of IU Health’s Dr. Chandrashekhar Kubal.

“What I’d tell someone thinking about becoming a living liver donor is to talk to your family first because surgery does not come without risks,” said Schmutte.

And on the day that Schmutte met Bilger for the first time, he said something else became very clear to him.

“I went into it with my focus on the recipient. After meeting her family, I realized it’s much bigger than that,” he said. Every family member wrote a personal letter to Schmutte expressing their appreciation. Bilger presented Schmutte with a special t-shirt and a key chain inscribed with a bible verse and the date of her transplant.

“It took me like three and a half pages of writing to express my gratitude,” said Bilger. “This is another miracle, another answered prayer. What do you say to express that kind of gratitude? It’s not like he pulled over and helped me change a flat tire. This is so much bigger and I think the best way to show my gratitude is to live the longest and healthiest life I can to take care of my family and to not take anything for granted.”