She''d never known anyone who''d had an organ transplant. So to say Amanda was surprised when Wilson''s disease caused her dramatic emergency liver transplant last December is putting it mildly.

Amanda is an athletic, 18-year-old from Carlinville, Ill. The third of four daughters of Carolyn and John Watermeier, she excelled in academics, volleyball and softball at Carlinville High School. Persistent abdominal pain sent her to her family doctor shortly before Christmas 2004. Her doctor suspected a digestive problem and ordered lab work. When test results indicated liver dysfunction, her doctor sent Amanda to St. Francis Hospital in Litchfield, Ill. She was then transferred to Barnes-Jewish Hospital.

The Washington University School of Medicine gastroenterology department has long been known for its expertise at diagnosing, treating and researching genetic diseases of the gastrointestinal system. The gastroenterology department''s hepatology team at Barnes-Jewish diagnosed Amanda as having Wilson''s disease, the rare genetic disorder in which the body fails to excrete copper, allowing it to build up and damage the liver.

Amanda''s liver failed. Working with the Washington University liver transplant surgeons at Barnes-Jewish, the hepatologists, including Kevin Korenblat, MD, determined that Amanda immediately needed to be placed on the waiting list for a liver transplant. “I was almost in disbelief,” Amanda said. “I was scared.”

When her vital signs suddenly crashed and her kidneys failed, she was rushed into intensive care. A donor liver was located outside of Missouri. In a rare procedure to save Amanda''s life, liver transplant surgeon Surendra Shenoy, MD, removed her necrotic liver, hoping to stabilize her condition. Dr. Korenblat and the team monitored Amanda throughout the night, waiting for the donor liver to arrive at Barnes-Jewish.

“The doctors and nurses were there, waiting with us and keeping us informed,” John Watermeier said.

After the transplant surgery, Amanda was kept in a drug-induced coma to allow her to heal from her catastrophic illness. Five days later, she awakened, asking, “Did I have the transplant?”

Weak from her ordeal, she spent about two more weeks recovering in the hospital, before returning to Carlinville. Within weeks, she returned to school. Remarkably, she not only regained her standing as one of the top students in the class, but also earned a position as a starter on the school''s varsity softball team.

Amanda''s sisters were tested for Wilson''s disease at Barnes-Jewish Hospital. One of her older sisters was found to have the disease, but it hadn''t yet caused damage like Amanda had. “I didn''t know the liver was so important and did so many things,” she said.

Her sister''s disease is now being controlled by medication.

Amanda graduated in May as one of the tri-valedictorians of her class. She plans to attend the St. Louis College of Pharmacy, and on earning her pharmacy degree, hopes to get a job at Barnes-Jewish Hospital on the transplant team — where she can help others as she was helped.