As a resident in Egypt, Dr. Kareem Abu-Elmagd saw more patients with diseased livers than he cared to see. They were young and suffering from liver fibrosis and cirrhosis, a scarring and degradation of the liver that can be caused by cystic fibrosis and other diseases. They were bleeding from the insides and dying.

"I was very discouraged by the number of young patients who were bleeding from their stomachs with cirrhosis. There was little we could do for them, and they would die," Dr. Kareem recalls.

He believes it was at this time that his interest in the intestinal tract began, setting him on a path to become a leader in the field of intestinal transplantation, at the University of Pittsburgh's Thomas A. Starzl Transplantation Institute.

"I believe that God prepares you for different missions in life," Dr. Kareem says.

In the 1980s, he moved to Atlanta, Ga., to complete a clinical research fellowship at Emory University School of Medicine. There he worked with Dr. W. Dean Warren, who helped create a surgical procedure (distal splenorenal shunt) to control bleeding in the liver and other intestinal organs.

At the same time, the rate of success for liver transplants started to improve with the development of a new anti-rejection drug.

"The shunt was a temporary solution to protect the liver from bleeding, but the liver transplant targeted the primary problem by replacing the liver," Dr. Kareem says.

By 1989 he was working on a fellowship at the Starzl Institute, when founder and pioneer in transplant surgery Thomas Starzl noticed him.

"He told me there was no need for me to do a fellowship, and that he wanted me to come work for him," Dr. Kareem remembers. "He made me an assistant professor, and we made a man-to-man agreement that I would never leave Pittsburgh."

He has since standardized intestinal transplant procedures and post-transplant care at the institute as a director.

"All along, God was preparing me for what I am doing now," Dr. Kareem says. "Everything that I have been trained in has helped and has significance."

This includes Gretchen's grueling six-organ transplant surgery, which replaced her stomach, small intestine, liver, pancreas and duodenum.

"It is the most complex surgery that any human being can take," Dr. Kareem explains.

According to Dr. Kareem, what made her transplant so unique is that the organs had to be transplanted as a block. The operation required a lot of coordination and cooperation among doctors of different specialties.

Even Gretchen's recovery would be unique. Dr. Kareem says most liver, kidney or even heart transplant patients are able to leave the hospital as soon as five days after surgery.

"The intestine is an unforgiving organ. Anything can happen, and you have to be on top of everything," he remarks.

The most common outcome for people facing Gretchen's surgery is death, according to Dr. Kareem. But there was a small chance of survival.

"Her chance was 5 percent, and as a human being she deserved that chance."

Dr. Kareem had to fight with surgeons who said they deserved the organs that Gretchen had been waiting so long for. They felt that she was most likely to die, so she shouldn't have the organs. But Dr. Kareem argued that those with a higher chance of dying should be at the top of the transplant list. Luckily, Dr. Kareem won that argument.

After watching the "Six-Organ Transplant" episode, Dr. Kareem says that he was very impressed with the way that Gretchen and her mother thanked the organ donor.

"I think that the greatest achievement of the 21st century has been the experimentation and clinical work in organ transplantation," says Dr. Kareem, who, along with his wife and kids, is an organ donor himself. "Organ donation is truly the gift of life. That's for sure."