As a child in Beirut, Lebanon, Ahmad Anouti, M.D., endured dozens of medical procedures, hundreds of medications, and numerous setbacks before a liver transplant at age 17 saved his life.

The obstacles he faced made him determined to become a physician and help others, Dr. Anouti said.

At 5 years old, Ahmad Anouti, M.D. already had dreams of becoming a doctor. For Career Day, the kindergartner dressed up as a physician.

“My sickness has been my biggest blessing,” said Dr. Anouti, a postdoctoral fellow in the Division of Digestive and Liver Diseases at UT Southwestern. “It gave me direction in my life, and now as a physician, has put me in a unique position to really be an advocate for my patients.”

At 11 weeks old, Dr. Anouti was diagnosed with biliary atresia, a congenital condition in which the tubes that carry bile from the liver to the gallbladder fail to form correctly, resulting in a blockage. He was treated at the American University of Beirut Medical Center (AUBMC), where he was believed to be the first AUBMC patient to undergo the Kasai procedure, in which the blocked bile ducts and gallbladder are removed and replaced with the small intestine. Biliary atresia is a rare disease, and without surgery, children usually do not live past age 2 without a liver transplant.

Biliary atresia is a blockage in the tubes that carry bile from the liver to the gallbladder. It occurs in 1 out of 14,000 babies.

While his health stabilized, when Dr. Anouti entered his teens he was weak and often short of breath or prone to fainting. He was then diagnosed with hepatopulmonary syndrome, an uncommon condition that affects the lungs of those with advanced liver disease. (Hepatopulmonary syndrome is a late complication of biliary atresia in patients who have developed liver cirrhosis.) Dr. Anouti’s hepatopulmonary syndrome became very severe at age 16, requiring continuous oxygen therapy.

Six days after undergoing a liver transplant at age 17, Dr. Anouti enjoys his first meal since surgery.

Driven to succeed despite the obstacles, Dr. Anouti received a liver transplant days before his 17th birthday and soon after finished high school. The challenges continued, however, and he soon developed acute organ rejection followed by post-transplant lymphoproliferative disorder, a life-threatening complication of anti-rejection medication. He would recover once again and doggedly pursued his education, ultimately graduating from medical school at American University in Beirut in May 2022.

Today, he is a postdoctoral research fellow specializing in hepatology, which is the study of the liver – and a field that he is intimately familiar with. He’s also an advocate for organ transplantation and strives to raise awareness of UT Southwestern.

Fortitude and serendipity

Luck played a part in Dr. Anouti’s journey.

When he was born, no physician at the hospital where he was being treated had experience performing the Kasai procedure. But by chance, a surgeon from the United States was visiting his relatives at the time and agreed to do the surgery. The palliative procedure gave Dr. Anouti several years before his health deteriorated again and he needed a liver transplant in his mid-teens.

Faced with long waiting lists in Lebanon and other countries, his family feared he would not get a lifesaving transplant in time. They traveled abroad, where Dr. Anouti was placed on a waiting list. Three weeks later he underwent the transplant. But soon after he developed post-transplant lymphoproliferative disorder, a condition that occurs because of EBV, or Epstein-Barr viral infection. It can sometimes progress to non-Hodgkin lymphoma, which happened in Dr. Anouti’s case. He underwent immunotherapy in Beirut and, as soon as he was able, returned to school.

Dr. Anouti takes a photo with the nurse who cared for him following his 2013 liver transplant.

When he was strong enough, Dr. Anouti enrolled at the American University of Beirut, where he began studying biology. Some people discouraged him from becoming a physician because he would need immunosuppressants for the rest of his life, which they believed could put his health at risk when treating ill patients. But he refused to give up his dream.

“Once I got sick, I started seeing all these gaps in the medical field and wanted to do something about it,” he said. “I understand patients and the pain they are going through with all the tests and procedures and unanswered questions.”

Inspiring firsthand experience

His determination to be a researcher and clinician led Dr. Anouti to UT Southwestern, where his story has inspired both patients and faculty.

Dr. Anouti is in a unique position to help patients facing transplantation, said Lisa VanWagner, M.D., M.Sc., Associate Professor of Internal Medicine and Director of Clinical Research in the Division of Digestive and Liver Diseases.

“He can bridge the gap between physician-scientists and patients, given his own personal experiences as both a patient and a provider,” Dr. VanWagner said. “His passion for helping others live well with a liver transplant and for helping patients and families navigate the emotions of needing and receiving a liver transplant make him a unique asset for transplant medicine.”

Thomas Cotter, M.D., Assistant Professor of Internal Medicine, agreed.

“Dr. Anouti is providing hope and leadership to a very sick and vulnerable population of young patients by drawing on his own incredible personal story,” Dr. Cotter said. “It has been inspirational to listen to him relate his own experiences, showing patients that there is light at the end of the tunnel as they begin to embark on their transplant journey.”

Dr. Anouti’s journey from liver failure as a teenager to transplantation and post-transplant complications as an adult mirrors the experience of so many transplant patients, said William M. Lee, M.D., Professor of Internal Medicine and a renowned specialist in liver disease. “That makes him a great spokesperson for transplant recipients – he will be a fantastic guide/advocate for so many in the future as well,” Dr. Lee said.

Giving hope to others

Dr. Anouti’s message to patients is borne out of his struggle to succeed while others told him he should consider another profession due to his health issues.

“I wanted to show that I could do it despite being sick,” he said. “I was always hard-headed and stubborn.”

Surviving so many health challenges motivated Dr. Anouti to seek out ways to give hope to others with biliary atresia.

“I want people to be aware of organ donation and rush to donate to save lives,” he said. “I want people to fund our research more to be able to help the hundreds of thousands of patients on the waitlist, waiting for a liver and not knowing if they will receive it.”

Dr. Anouti celebrates his 2022 graduation from medical school.

After earning his medical degree, Dr. Anouti moved to Dallas to become a postdoctoral research fellow in hepatology. He applied to UTSW because of its excellent liver transplant program, he said.

“The liver transplant program is not just phenomenal, but many breakthrough techniques are being done at UTSW such as living donor liver transplants and machine perfusion of livers,” he said.

As soon as he arrived, Dr. Anouti got involved with advocacy work on behalf of UT Southwestern and other organizations in his effort to encourage organ transplant. He is a member of the American Liver Foundation (ALF), a committee member of the ALF Biliary Atresia board, a member of the Global Liver Institute, and a member of the Biliary Atresia and Research Awareness.

“I want people to realize that giving an organ is such a noble thing to do after someone dies,” he said.

Dr. Anouti poses with his wife, Aya Sukkar, on their wedding day in 2022.

Today, Dr. Anouti is healthy and enjoys working out and spending free time with his wife. He will finish his postdoctoral research fellowship in 2024. He then plans to apply for a residency in internal medicine followed by a gastrointestinal fellowship and then a transplant hepatology fellowship. His ultimate goal is to become a transplant hepatologist.

He remains optimistic that he can achieve his goals.

“I’m doing very well and living life fully,” he said. “I just appreciate life so much.”