SIOUX CITY -- Katie Canoles, a dental assistant and mother of two young girls, was at the gym working out during her lunch break in early November, when she received a call informing her that she was a match to donate a portion of her liver to her aunt, Julie Peiffer.
Canoles, 32, of Sioux City, recalls turning to her coworker, who was riding an exercise bike next to her, and saying, "I'm a match!"
The next night, Canoles and her husband went to Peiffer's Hinton, Iowa, home to deliver the news. She asked Peiffer to get out her day planner. Peiffer responded, "I just use a calendar. Why?"
Canoles said, "Well, I want to know when is a good time for you to get a new liver."
Peiffer, 64, burst into tears. She couldn't believe that Canoles, just the second family member tested, was a match.
"The chances are 5 percent of having a live donor. I was never expecting that," said Peiffer, whose health was deteriorating. "It just happened at the perfect time."
Ten years ago, Peiffer was diagnosed with hepatitis C, a viral infection that causes serious liver disease and liver cancer. Peiffer contracted the virus through a blood transfusion she had after the birth of one of her three children.
"We don't know which one, because they didn't check the blood back then like they do now. I had blood transfusions with all of them, so somewhere along the line I got infected blood," explained Peiffer, who said one of the first signs of the disease she experienced was tiredness.
Last summer, an MRI detected a small tumor on Peiffer's liver. Doctors encouraged Peiffer to have her family members begin testing to see if any of them would be a match to donate a portion of their livers. Peiffer, who was also placed on a waiting list to receive a liver from a deceased donor, began chemotherapy treatments.
"They told me at that time there was a little gray area; and then by December, that gray area they could say was another tumor," she said. "It wasn't a surprise to me. I kind of took it in stride, really."
Canoles wanted to be tested to see if she might be a match, but before the testing could even begin, she had to lose 30 pounds to meet body mass index requirements.
"I just remember mom calling and saying, 'Julie needs a transplant,' and I said, 'I would be more than willing to see if I was even a match,'" she said. "I sat down with my boss and I sat down with my husband and I sat down with my parents and I said, 'I want to do this.'"
Another of Peiffer's nieces, Nancy Huber, was tested first, but she wasn't a match. Canoles began the process in late October after losing weight through a combination of intermittent fasting and cardio exercises. Her weight, as well as her age and height, met donor requirements and her blood turned out to be a compatible match with her aunt's.
"One of the questions we had to fill out was, 'Why do you want to be a donor?' I remember putting on there, 'I'm just not ready to lose her,'" Canoles recalled. "It never hit me how scary it was. I don't think it ever hit me how bad of a situation it was going to be. I just wanted to make sure that she was going to be OK; and if I could make her be OK, then I was willing to try it."
At Nebraska Medicine in Omaha, Canoles underwent a battery of tests, including a chest X-ray, MRI, CT scan and EKG.
"It all depends on the size and making sure the arteries and bile ducts and everything lines up, mine to hers," Canoles said.
Peiffer expected the process of finding a match among family members, if one could even be found, would take a few years. She said she is "amazed" that a living donor was identified so quickly.
'I'd do it again'
Peiffer and Canoles arrived at Nebraska Medicine together at 6 a.m. on Dec. 27.
Before surgery, the two held hands and hugged. Family members filled the waiting room.
"I remember wheeling past you in the hallway and trying to wave," Canoles said to Peiffer, while the two recounted their story at Canoles' parents' Sioux City home amid laughter and tears. "They had given me the drug and I couldn't lift my hand to wave. They had just brought you back to get your pre-op started as they were wheeling me into surgery."
Surgeons removed Canoles' gallbladder and the right lobe of her liver. Her right lobe was then transplanted into Peiffer's body after her diseased liver was removed. After surgery, a donor's liver regenerates back to full size, while the patient's new liver also grows to a normal size.
Peiffer and Canoles were reunited and walking the halls a couple days later.
"I cried a lot. It was so surreal," said Peiffer, who still tears up when she thinks about the life-saving gift her niece gave her. "She did something so amazing that not just anybody can do."
Canoles expected to spend two weeks in the hospital, but she was discharged after just a week. Peiffer anticipated being hospitalized for two to three months, but she was cleared to leave after a month.
"Everything that transpired from Katie being a match to today, and the rest of my life, it all has to do with God," Peiffer said.
After they were released from the hospital, Peiffer and Canoles both stayed with Huber, who just happens to live in Omaha. Canoles spent about seven days at Huber's home, while Peiffer was with her for two weeks. Peiffer returned home to Hinton the first weekend in February.
"She was just amazing running us around and getting our pills and scooting us to bed," Peiffer said of Huber.
Canoles added, "I think God didn't make her a match, because we needed her to take care of us. She was our angel."
Both Peiffer and Canoles said they had a hard time just sitting back and relaxing during their recoveries. Both women are used to being on the go. Canoles said it was also tough being away from her daughters, but reflecting back on the experience and seeing how well her aunt is doing today, she said she'd do it again.
"Not that it wasn't hard, but it wasn't that bad for me. I think it's so worth it," she said. "If she needed it again, I'd do it again."