There are 7,253 people in Pennsylvania waiting for an organ transplant — the only chance to save their lives.

“It would mean the world to me,” said Lorraine Skomo, a Center Township resident who needs a liver transplant.

Skomo, a retired nurse with autoimmune cholangitis, is among Butler County residents who have waited over a year for a vital organ — trying to find a perfect match.

For the last 18 months, Lorraine and her husband, David, have explored multiple avenues to find a transplant donor for her liver — searching the internet, putting her plight on placemats in restaurants, hanging up posters, placing classified advertisements in the Butler Eagle, and even ordering a billboard.

“We haven't had any progress,” Skomo said. “I'm not getting better. I'm getting worse.”

Doctors understand the transplant process is emotional for everyone involved.

Dr. Manreet Kanwar, a cardiologist at Allegheny General Hospital, said some patients tell her, “Someone had to die so I could live.”

She argues this statement is not accurate: The donor did not have to die to help a patient live.

“They chose to give this gift,” Kanwar tells them. “And we need to embrace it.”

While UPMC performs heart, lung, pancreas and intestine transplants, the ability to use living donors for livers and kidneys gives patients another option.

“The sad fact is that many people die waiting for a liver or a kidney,” said Travis Watson, UPMC in Pittsburgh transplant administrator. “They really don't have to.”

With an organ team of 400 doctors, nurses and support staff, UPMC Presbyterian Shadyside completes about 400 transplants a year, making it one of the largest transplant centers in the United States.

“We also perform more living donor liver transplants than any other center in the country,” Watson added.

Ideally, Skomo will find her perfect match.“The great thing about the liver is you're getting a piece,” Skomo said.

The liver is the only visceral organ with the ability to regenerate. A section taken from a living donor and given to someone will grow to full size. Both donor and patient recover.

“I can do anything now I want,” said Brenda Clifford of Middlesex Township, who donated part of her liver to her mother in 2005.

Clifford, then 45, was back to riding horses and bowling within a year.

It is a life-impacting decision accompanied by forms, tests, surgery, recovery time.

For Clifford, what remains of the procedure 14 years ago is a scar shaped like the Mercedes-Benz logo.

She urges others to give the gift of life.

“Do it,” Clifford advised. “Make sure your family is aware of what you want.”

Blood need also high

Retired Army police Sgt. First Class and veteran Joseph Henricks has colon cancer and needs O-positive or O-negative blood to battle microfractures in his colon.

At his last blood transfusion, the Butler man was scheduled to receive two bags of blood to raise his hemoglobin, but received just one. “Due to the shortage of O-positive in the country,” Joseph's wife, Caroline, said. “Everybody needs donations.”

“O blood is always needed,” said Kristen Lane, Vitalant blood bank spokeswoman. “Especially O negative.”

Type O blood is considered universal because anybody can use it. This is especially important for victims in trauma situations, such as car crashes and shootings.

Lane said there isn't enough blood in hospitals to handle major emergencies, in which case blood needs to be transported from another city.

“It's the blood that's already at the hospital that saves a person's life,” Lane said. “You can't wait for a disaster to donate.”

Vitalant needs 600 donors a day to keep up with the blood demands of hospitals across Western Pennsylvania. “We're seeing fewer than half that number,” Lane said. “We are in absolutely desperate need (of) blood donors.”

Colon cancer — and the need for blood — has taken a toll on Joseph's activity level. He used to work eight-hour days before coming home and working around his home. Since his diagnosis in April, Joseph has lost more than 60 pounds and sometimes can't stand by himself.

Dealing with the blood shortage has been difficult for the couple and their family. “It has a major effect on all of us,” Caroline said.

The Henricks family has a blood donation setup with Vitalant. Caroline realizes Type O is needed across the country, not just in the Henricks' home. If Joseph's hemoglobin levels stabilize, any extra blood donated in his name will be sent to other patients.

“I don't want it to go to waste,” Caroline said. “O- positive is needed throughout the United States.”

The waiting game

Getting an organ is a “lengthy and comprehensive process,” UPMC's Watson said.Each patient is evaluated by specialists, surgeons, coordinators, financial counselors, social workers and nutritionists. Extra testing is done to ensure the patient is a good transplant candidate. Then, the patient becomes part of a national transplant list. Many elements determine how quickly a transplant takes place, particularly the patient's level of need and blood type. “The waiting time can be weeks, months or even years,” Watson said.Patients don't always know if or when they'll get help. Some organs — like hearts — must be transported from donor to patient within hours after death.Organs can't be retrieved until a potential donor is brain dead. Only then do donation talks begin. An organ “offer” may or may not be made to transplant services.Organs are removed from the body based on significance. “The heart takes priority over everything else,” Kanwar said. “Most (potential) recipients die waiting for a heart. The human heart can only be sustained outside the human body for about three hours.”Kanwar said the procedure must take less than four hours.Ideally, recipients are no more than 500 miles from their donor. But when a heart is available, transplant centers usually take the offer no matter the distance.But for patients on the transplant list, the wait can be long excruciatingly long.“It can be in years,” Kanwar said. “It can be in days.”Time for surgeryThere are 164 Pennsylvanians waiting for a heart. Paul Raab was lucky enough to receive one after just one month of waiting. The Butler man and former construction worker received a heart transplant in 2016.He knows his experience isn't normal. “My old heart was rather bad,” Raab said. “I was running really close to pushing up daisies.”Raab didn't know a heart was lined up for him until his doctor walked into his room and told him. The transplant surgery took 10 hours at AGH, according to Raab.Raab had a pacemaker to manage his ventricular tachycardia (rapid heartbeat) when his doctor told him he was having too many issues and needed a transplant.“I said that's fine; let's get 'er done,” Raab said.For Raab, the hardest part of the experience was not being active.Post-transplant, he goes to the gym five to seven times a week, walks three to four miles a day and pours concrete for fun.“I'm not a couch potato,” Raab said. “No limitations, they say.”Raab is on some medications — specifically, an antirejection drug for his heart — but not as many as he was before.Although doctors told him he has recovered very well, Raab credits his doctors with his success. “People shouldn't be scared,” Raab said. “If you're in good hands, they do everything that's humanly possible to make you comfortable.”Facing the billsTransplants are expensive. While most major insurance plans cover transplant costs, there are still nonmedical bills such as transportation and lodging that patients pay out-of-pocket. Watson explained in cases where organs must be flown in from another state, transportation costs alone can be over $20,000.“Our social workers educate our patients on these costs and help them develop a plan to pay,” Watson said.Patients who don't have insurance may pay in excess of $100,000, with up to $15,000 in medical costs annually after surgery takes place.Kanwar said the procedure for a heart transplant without complications costs insurance companies about $700,000. AGH has financial consultants who work directly with patients.Raab's heart transplant cost upward of $1 million. He paid $4,000 himself.While living donors aren't paid for their organs, there are some reimbursements available for items such as lodging and time taken off work for the procedure and recovery.UPMC also makes sure to educate both patients and donors on the legal side of the process.“We're always looking for ways to increase our community outreach to serve our patients and living donors,” Watson said.Life goes onSkomo's illness makes her tired and confused and causes sleep disturbances, among other things. The medicines she takes to manage it include diuretics that keep her close to home.She's missed family gatherings and meals given in her honor, which she regrets. Skomo also misses her hobbies, particularly acrylic painting. “I really love doing that,” Skomo said. “But with all the medications I take for the disease, I get so tired.”Some medicines also give her tremors, which prevent detailed work. “Maybe I'll have to go into abstracts,” Skomo joked.While Joseph Henricks battles his disease, his wife prepares to go back to work. She drives a school bus in the Seneca Valley School District and returns to the road this fall.Henricks has a MedAssist health care worker who visits twice a week. “(They) are wonderful,” Caroline said. “These ladies run all over Butler County trying to help people.”Raab believes his heart gives him new opportunities, like seeing his young grandchildren and taking family trips to Disney. He's making the most of his transplant.“Once you get that second chance, don't sit around,” Raab said.Eagle associate managing editor Donna Sybert contributed to this report.