By Doug Moore, St. Louis Post-Dispatch, August 13, 2007

MARISSA - Gary Thornton devours a snack cake and a glass of milk. He checks his cell phone for messages. He laces his conversation with sarcastic humor.

He''s a young man in a small town, who hunts squirrels and rides four-wheelers with his friends when not raiding his older sister''s refrigerator.

He fishes in the lake behind his parents'' house. He loves the water and typically cools off with a daily swim.

Not this summer, however. The large scar on his abdomen has not healed fully and he cannot risk infection.

He sees it as a small sacrifice as his new liver gets comfortable with a 23-year-old''s body. Thornton''s doctor says he is doing remarkably well 2½ months after surgery and should lead a normal life - something Thornton has not had since birth.

"He got under 5 pounds when he was born. He looked horrible. I didn''t think he''d pull through," said his mother, Wanda Thornton.

Her son was born with three birth defects. Doctors first noticed that his esophagus was not attached to his stomach and rushed to fix it. Doctors also monitored a hole in Thornton''s heart, anticipating that it would eventually get smaller, which it did.

A few weeks later, while still being treated for his esophagus surgery, he began turning yellow. Doctors checked his liver. He was born with malformed bile ducts. Within two weeks, bile had backed up, causing cirrhosis of the liver.

Doctors performed the Kasai procedure, where the liver is hooked directly to the intestines. It''s considered a temporary fix until a baby can grow a bit and is better suited for a transplant. In Thornton''s case, however, the procedure lasted more than 20 years, although he had complications in adolescence, including internal bleeding.

In January, he began getting sicker. His skin and eyes were yellow. He was losing weight. The bleeding became more severe. His liver was failing. It was time for a transplant.

His waiting time was short. A match came in 10 days - May 23. He had been for a swim in his parents'' lake earlier that day and had just headed over to his girlfriend''s house in nearby Sparta that night when his mother got the call from Barnes-Jewish Hospital.

"I called him to tell him the call came," Wanda Thornton said. "He thought I was kidding."

Gary rushed home, showered and packed a bag. His mother, ready to head to a night shift at her foundry job, called to say she couldn''t make it. His father, Gary Sr., jumped in his pickup and drove his wife and son 50 miles to Barnes.

By 11 p.m., two hours after the call, Thornton was being prepped for surgery.

Dr. Will Chapman, head of the hospital''s abdominal transplant section, was Thornton''s surgeon. Thornton''s scarring from his surgery as a baby made his transplant more complicated. He was on the operating table about seven hours.

Thornton''s case was unusual in that the transplant came so long after the Kasai procedure.

"To go 20 years and then need a transplant, that''s uncommon," Chapman said.

It''s been at least four years since Barnes has operated on an adult with biliary atresia, the medical term for being born with malformed bile ducts. Chapman is happy with Thornton''s progress.

"His liver should last him as long as he needs it," Chapman said, as long as Thornton continues his medication - which currently includes 22 pills a day to prevent his body from rejecting the liver - and takes care of himself.

He also should avoid alcohol, something Thornton said he had already given up after a high school friend was killed in a drunken driving crash.

Organ recipients are not given information about their donors. Thornton and his family want to send a letter of thanks, which the hospital can pass along. They''d like to meet the relatives of the young person whose death from severe head trauma resulted in Thornton''s life-saving surgery.

"There''s no way you can thank someone enough for a life," Wanda Thornton said.

"We know what we want to say. We just don''t know how to begin the letter," said Thornton''s oldest sister, Natalie Krause.

Thornton is on disability from his factory job at Gilster-Mary Lee Corp. in Steeleville, Ill. He''d like to find a job where he doesn''t have to lift so much. Although his family agrees, they do not seem thrilled that he wants to become a coal miner like his buddy, Joe Impastato.

Impastato bought a five-bedroom house from his mom and he, Thornton and another friend, Steven Hand, are living in it while they rehab it.

Thornton has to have his blood drawn weekly. Each week, his mom helps him sort his medication into daily piles. His sisters, Krause, and Lisa Keffel, continue their roles as doting older siblings.

Wanda Thornton misses having her youngest child at home, where she can keep a closer watch on him. He''s been craving independence and his new liver is helping him get there.

"He''s had a battle, but I''m telling you, he''s a fighter," she said. "I have to let him go some time."