Andy, his wife, and their baby huddled together for new family photo shoot.

| one year ago

Waiting for Two Big Arrivals: A Liver and a Baby

In 2022 the millionth organ transplant in the U.S. took place and Atrium Health is proud to be part of that amazing accomplishment. Andrew Neelands is one of our patients who got a second chance at life thanks to a liver transplant.

Andrew Neelands and his wife Cassie were thrilled when they found out she was pregnant, but they were also worried: Andrew, who was just 31-years old, had cirrhosis and needed a lifesaving liver transplant.

Cirrhosis, sometimes called end-stage liver disease, causes scarring that damages the liver, preventing it from properly working. It was the scarring that led to Andrew’s diagnosis.

In 2014, surgeons performing routine gallbladder removal surgery on Andrew happened to notice scarring on his liver. Shortly thereafter, Andrew was diagnosed with nonalcoholic fatty liver disease, a condition in which fat builds up in the liver and alpha-1 antitrypsin deficiency (AAT deficiency), a genetic condition in which AAT proteins aren’t correctly made and get stuck in the liver as a result. These conditions led to Andrew’s cirrhosis.

Through referrals, Andrew found his way to Dr. Andrew DeLemos, a transplant hepatologist at Atrium Health Transplant and Liver Center.

DeLemos and his team cared for Andrew over the years, evaluating his condition and providing treatment as needed.

The turning point

In November 2021, things took a turn for the worst. Andrew began gaining weight, had severe heartburn and his legs started to swell. The swelling was gradual but alarming.

DeLemos evaluated Andrew’s condition and determined that he needed to go on the liver transplant list.

“The worse you get, the higher up you move on the list,” shares Andrew. “And you need to be ready to go to the hospital 24/7 because you never know when a liver will become available.”

DeLemos encouraged Andrew to have a goal he could focus on during the transplant process. “Because it gets hard as you’re waiting and waiting and getting sicker and sicker, so you need something positive to focus on to carry you through it,” Andrew says.

Andrew’s goal was meeting his son, who was due in early August.

“Dr. DeLemos said, ‘Then that’s what we’re going to do. We’re going to do everything in our power to make that happen,’” says Andrew.

The call

On Friday, July 15, 2022, Andrew’s weekly lab results were the highest they’d ever been, which meant his condition was the worst it had ever been. He had a feeling something would happen soon.Andy posing with his baby in front of John Deere tractor.

DeLemos had the same feeling when he saw Andrew’s results and told the liver transplant coordinator to be ready. The coordinator then called Andrew to make sure he saw how high his results were, urging him to stay close to the phone.

And sure enough, the liver transplant coordinator called again a couple of hours later: They had a possible liver for Andrew.

“I was extremely emotional when I got the call,” says Andrew. “I felt happy and excited, but at the same time, I had to balance that with the reality of how this liver was coming to me. Someone had to die to give me a second chance at life.”

At 9 p.m. the following evening, Andrew went into surgery at Atrium Health Carolinas Medical Center, and the transplant was a complete success.

“I cannot overemphasize the level of teamwork it takes to perform transplant surgery,” says Dr. Vincent Casingal, chief of the division of abdominal transplant surgery at Atrium Health. “It includes critical care, anesthesia, skilled operating room staff, cardiology, nursing, respiratory, perfusion and advanced practice providers to make the case successful.”

The recovery

Andrew’s first memories following surgery are seeing his wife sitting beside him and realizing he already felt so much better thanks to his new liver.

Still, he had to spend two weeks in the hospital recovering. Getting out of bed and moving around was a big part of the recovery and his care team encouraged him to do more and more every day. Eventually, he was doing laps around the floor.

Oh baby!

On August 4, 2022 – one week after Andrew was discharged from the hospital – his son Marshall was born.

“My wife and I had to have the conversation multiple times about if I was going to be too sick to help out with the baby or if I was going to even be here,” recalls Andrew. “But we’re lucky that everything turned out perfectly.”

“On my worst days when I felt terrible and couldn’t get out of bed, my care team would uplift me and keep me focused on what I was fighting for – to see the birth of my son,” he says. “Everybody on my team, from the transplant coordinators to the nurses to Dr. DeLemos, wanted me to get this transplant and succeed. I can’t say enough good things about the care I received.”

Thanks to the generosity of a liver donor, Andrew has a second chance at life. More than 100,000 people are waiting for lifesaving organ transplants in the United States. One donor can save up to eight lives, restore sight to two people through cornea donation and heal more than 75 lives through tissue donation. Visit to learn more about donations and to register to be a donor.

Learn more about liver transplant care at Atrium Health.