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Waiting for a new liver, Forsyth County teen’s former teacher came to the rescue
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On Feb. 3, 2020, Gena Garner (left) will donate a portion of her liver to Riley Highland (right), who Garner taught Spanish to in kindergarten and first grade at Chattahoochee Point Elementary School. - photo by Ben Hendren

With the start of the new school year in August, Gena Garner began a new job as a Spanish teacher at North Forsyth Middle School with a caveat: she would have to take about two months off during the year to recover after donating half of her liver to her sister, Kristen Lowder, who has struggled with liver issues for more than 20 years.

At least, that was the plan. Lowder moved from Knoxville to Forsyth County to be closer to Garner for the potential transplant. Both Garner and Lowder underwent lots of tests. But just before the final round of testing, Lowder found out she would be getting a liver from a deceased donor.

After the surgery, a college friend of Lowder’s was telling their neighbors, Chris and Micki Highland, about Lowder’s story. The Highland’s 16-year-old daughter, Riley, was also on the waitlist for a liver donation.

About a month later, in October, Chris, a counselor at NFMS, was talking with Garner, and the conversation turned to the liver donations both families were dealing with.

“They came together talking at some point, and just out of the blue, Chris starts just talking about Riley’s story a little bit,” Micki recalled, “and Gena says, ‘Well, I was going to donate my liver to my sister, then she got one. I’ll donate to Riley.’”

Chris said he was in shock and told Garner to speak with her family before making such a big decision, but Garner was undeterred.

On Feb. 3, Garner will donate more than half of her liver to Riley, who Garner taught Spanish to in kindergarten and first grade at Chattahoochee Point Elementary School.

“I’m ready,” Riley said. “I’m kind of nervous, but I’m mostly excited for it.”

“I’m ready,” said Garner. “In the back of my mind, I’m like, ‘She’s going to get a phone call and get a liver, and I’m not going to be able to do this.’”

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“I’m ready,” said Riley, 16, who attends Alliance Academy for Innovation. “I’m kind of nervous, but I’m mostly excited for it.” - photo by Ben Hendren
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“I feel like God has worked all of this out because it’s come together like pieces of a puzzle,” said Gena Garner, a Spanish teacher at North Forsyth Middle School. On Feb. 3, 2020, Garner will donate more than half of her liver to Riley Highland, the daughter of one of Garner's colleagues at the school and a former student of Garner's in kindergarten and first grade at Chattahoochee Point Elementary School. - photo by Ben Hendren

Due to the age difference, Garner and Riley will be in separate hospitals for surgery and recovery.  Garner’s donation will happen at Emory Hospital’s transplant center, and once a portion of the liver has been removed, it will cross the street to Riley at Children Healthcare of Atlanta’s Egleston Hospital.

“They tell us because the way Gena’s liver is shaped and the fact that Riley needs an adult liver, I mean she is an adult girl now, they’re going to take over 60% of Gena’s liver,” Chris said. “So for a few weeks, Riley will literally have more of Gena’s liver than Gena has. It’s mind-boggling. Then, within, they say, about eight weeks, both livers will be full-sized.”

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"So for a few weeks, Riley will literally have more of Gena’s liver than Gena has. It’s mind-boggling," said Riley's dad, Chris Highland, a counselor at North Forsyth Middle School. "Then, within, they say, about eight weeks, both livers will be full-sized.” - photo by Ben Hendren

Riley went back to the waitlist, and stress consumed the family.

They couldn’t be more than a few hours away from the hospital, so they canceled a planned trip to Alaska.

There were even some false alarms. A few months ago, they got a call late at night to indicate Riley was high on the list for a liver donation. They stayed up all night waiting to find out. At 4 a.m., the hospital called again – another person got the liver.

“We’re in transplant purgatory because you really can’t do a whole lot because you never know what’s going to happen or when you need to be somewhere,” Chris said. “You’ve got to keep your phone on 24/7.”

As Riley, a student at Alliance Academy for Innovation, deals with an estimated three-month recovery, she will continue classes through the hospital homebound program until she is can return to school.

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“It’s one thing to get an organ from someone who is deceased,” said Riley's mom, Micki Highland. “It’s a completely different thing to get one from someone who is willing to go through a surgery for it and all that and affect their family. - photo by Ben Hendren

For Riley, the family first noticed problems more than four years ago, when she was running track in middle school and started feeling abdominal pains. After going to a doctor, the family eventually went to a specialist at Egleston, who diagnosed Riley with auto-immune hepatitis and, after a biopsy, primary sclerosing cholangitis, or PSC.

“As we found out through the years, the auto-immune hepatitis was not the real problem, the PSC is the real problem,” Micki said. “That isn’t curable. The only way to [cure] that is to have a liver transplant.”

At that time, Riley was put on the liver waitlist but was able to manage the disease through medication, which made her inactive on the list until last May, when she was hospitalized.

The original plan was for Micki to donate a portion of her liver, but plans changed when the hospital found early breast cancer, meaning she couldn’t donate. Micki underwent a double mastectomy in October.

“I was heartbroken,” Micki said, “because I was expecting to have a surgery, just not the one I actually had.”

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Riley Highland, 16, was diagnosed with auto-immune hepatitis and primary sclerosing cholangitis four years ago. - photo by Ben Hendren

For Garner, this is her third attempt to donate an organ, following planned donations for her sister and father, and all the variables involved make it hard to believe it’s a coincidence, from teaching Riley to working with Chris to Lowder’s friends being the Highland’s neighbors to Garner having previously gone through testing for a donation, which sped up the process.

“I feel like God has worked all of this out because it’s come together like pieces of a puzzle,” Garner said.

Garner said “the words just kind of came out” for offering her liver before even speaking with her family. Since then, the families have gotten closer, and Garner said her son even joked that he was looking into donating organs because of all the food, cleaning and well-wishes coming from the community.

As both families prepare for surgery, they said they want to spread the word about organ donation and how one donation can create a chain reaction.

“Because [Lowder] got a donation because of an organ donor, I was available. Had she not gotten it, we wouldn’t be here,” Garner said.

While many might have plans to be organ donors once they pass away, the families also urge individuals to look into live donations of organs, which can be done for kidneys and livers and in rarer circumstances lungs, intestines and pancreases.

“It’s one thing to get an organ from someone who is deceased,” Micki said. “It’s a completely different thing to get one from someone who is willing to go through a surgery for it and all that and affect their family. It really is a bigger deal, but it’s lifesaving.”