Why I flew to Turkey to donate part of my liver to a man I hardly knew

By LUCY ELKINS, GOOD HEALTH CONTRIBUTING EDITOR Published: 00:59, 14 July 2026 | Updated: 00:59, 14 July 2026 Nail technician Sara Joseph doesn’t consider herself brave. ‘I’m scared of just about everything’, she says. But after what she willingly put herself through this year, many would disagree. In March, Sara flew to Turkey to undergo five hours of gruelling surgery to donate almost two-thirds of her liver to someone she had met only a handful of times. Astonishingly, despite facing months of recovery and permanent scarring, Sara signed up to be a potential donor hours after seeing a friend’s Facebook appeal. ‘If you have the opportunity to save a life, why wouldn’t you?’ says Sara, 50, who lives in Bushey, Hertfordshire, with husband Lloyd, 57, a charity administrator, and children Dylan, 22, and Josie, 20. Hers is an extraordinary story of self-sacrifice. But it also raises questions about the NHS guidelines for liver transplants. For the man whose life she saved, James Conradi, 39, has gone from strength to strength since receiving part of Sara’s liver in March. Last month, he returned to work full-time; he is once again taking his son to school and settling back into family life. Yet James had not even been allowed to join the NHS waiting list for a liver transplant after being given three to six months to live in February. ‘Without Sara I would not be here now,’ says James, a human resources manager who lives in Radlett, Hertfordshire, with wife Laura, 41, a tattoo artist, and their son Harrison, nine. In 2013 he was diagnosed with primary sclerosing cholangitis, an auto-immune condition in which the immune system attacks the bile ducts in the liver. These carry bile, which helps digest fats, but when damaged, bile builds up in the liver, gradually destroying it. Nail technician Sara Joseph, 50, donated part of her liver to James Conradi, 39, a man she had met only a couple of times - her husband now describes them as ‘the liver in-laws’ James knew he might one day need a transplant. And by February this year it was clear that day was approaching. ‘I lost a stone in one week as I felt too unwell to eat,’ he says. His face and eyes turned yellow due to jaundice – a sign the liver isn’t working. Then came the devastating blow: a scan revealed two tumours in his liver, a known complication of his condition. Under NHS guidelines he was told that having more than one tumour ruled him out for a transplant. ‘I don’t often cry but I shed tears then,’ says James. ‘Telling my son about my diagnosis was the most difficult conversation of my life. I told him Daddy needed a new liver and that hopefully he’d get one, but it wasn’t going to be straightforward.’ Restrictions on liver transplant recipients in the NHS are there ‘to ensure that those who do get listed have the best chance of still being alive after five years’, says Varuna Aluvihare, transplant hepatology lead at King’s College Hospital in London. ‘The number of donors we have doesn’t match the number we need so we have to be cautious.’ At any one time, around 500 people are waiting for a liver transplant in the UK and ‘hundreds die each year while waiting for one’, says Pamela Healy, chief executive at the British Liver Trust. It was James’s consultant who told him, ‘If you were my brother, I would be telling you to look at international options to have a transplant’. Turkey is one of several countries that have less stringent criteria for transplants and ‘if you’re prepared to pay will take on cases that we in the NHS would deem to have a less satisfactory chance of survival’, says Dr Aluvihare, who is also chair of the Liver Advisory Group that oversees the UK liver transplant service. NHS Blood and Transplant warns anyone considering travelling overseas: ‘Getting a transplant quicker does not necessarily mean better.’ Dr Aluvihare adds: ‘We don’t have control of the regulations and the quality of care surrounding it abroad. It’s not always the right decision.’ Healthy adults can safely donate up to 65 per cent of their liver because the organ has the unique ability to regenerate Countries such as Turkey also have well-established live donor programmes because there are relatively few deceased donors due to religious and cultural reasons. Meanwhile, live donations account for less than 3 per cent of liver transplants in the UK, where 883 (of both kinds) were carried out in 2024-25, says Dr Aluvihare. But the hope is live donors will become more common. At King’s, for instance, the aim is for live donations to eventually account for around one in ten liver transplants, says Dr Aluvihare. A healthy adult can safely donate up to 65 per cent of their liver because the organ has the unique ability to regenerate. It begins regrowing within 48 hours and usually returns to its original size within two months. ‘Ethically, live donation is difficult,’ says Dr Aluvihare. ‘You are taking a healthy person and putting them through a serious operation, which leads to scarring and the risk of infection.’ There is also a risk of death, although Dr Aluvihare emphasises this has never happened in the UK. ‘The real growth in demand for transplants is from those with fatty liver disease,’ he adds. ‘Fat causes injuries to the liver similar to alcohol,’ he explains, eventually causing scarring so severe the organ can no longer function. Then there are liver diseases such as James’s for which still there is no cure. In all cases, a transplant can be transformative, says Dr Aluvihare. It was by chance that, in February, Sara came across the Facebook appeal by James’s wife Laura (the women had been friends for 20 years after meeting through work), for someone willing to donate part of their liver to James. Sara, who was still grieving after losing her mother to cancer, instinctively felt she should help. ‘It gave me comfort to think that I could help prevent another family going through the pain that I was going through,’ she says. ‘If you have the opportunity to save a life, why wouldn’t you?’ says Sara. James says '‘Without Sara I would not be here now.'  Her husband and children supported her and while one friend tried to put her off, ‘my mind was made up’, she says. She messaged Laura – and within days went for a blood test at a private clinic in Elstree, which confirmed she was a suitable match. ‘I went to James and Laura’s house the day after that,’ she recalls. ‘Seeing them as a family reassured me I was doing the right thing. James was so young and so bonded to his son – I couldn’t imagine Harrison not having his dad about.’ There were still hurdles. As well as being a blood match, Sara’s liver had to be in good health and anatomically suitable for donation. James and Laura also had to fundraise £250,000 for the operation and travel – which they did within a week, thanks in part to an influencer friend with a big network. ‘People were touched by our story,’ says James. On March 1, Sara, James and Laura – and two other potential donors, friends of James’s – flew to Istanbul where the surgery was to take place. Sara assumed she’d be the least likely match. ‘The other two were young blokes while I’m a 50-year-old woman.’ But scans and a biopsy proved Sara’s liver was the most suitable. ‘James and I did a fist bump,’ she says. Before surgery, Sara appeared before a hospital panel to confirm she was donating voluntarily and had not been pressured. With that hurdle cleared, the surgery was planned for March 13. Sara and James say they both felt ‘strangely calm’ the night before. Sara spent five hours in theatre, while James’s operation – to remove his diseased liver and replace it with the right lobe of Sara’s – took eight hours. Sara, who had a large cut across her stomach, was ‘in a lot of pain’ over the next few days. Even coughing was uncomfortable. Within days, James’s skin lost its yellow hue and his energy returned; signs the new liver was working. Sara was well enough to return to the UK a week later. James followed two weeks after. But days after her return, Sara felt feverish and ‘really unwell’. She spent five days at Watford General Hospital, receiving intravenous antibiotics as doctors feared an infection. Back home, she began bringing up bile and, as her condition deteriorated, was readmitted, this time to the Royal Free Hospital, which was overseeing James’s care. ‘I thought I was going to die,’ says Sara. ‘I was sweating and in so much pain.’ Scans discovered bile was leaking from a surface of the liver cut during the transplant – a complication affecting 2 per cent of living liver donors. She was pumped full of antibiotics to stem the resulting infection. ‘It was a difficult time, far worse than what I went through in Turkey,’ she admits. Discharged days later with oral antibiotics, she remembers ‘very little’ besides the constant flow of well-wishers to her home. Despite being barely able to leave the sofa for weeks, Sara calls it a ‘blip’. ‘The point is, James would be dead without my liver,’ she says. She speaks proudly of his recovery. Her husband jokingly calls James and Laura ‘the liver in-laws’ and the couples now regularly spend time together. ‘We have a bond that can’t be broken – a part of me lives in James,’ says Sara. James takes a cocktail of pills to stop his body rejecting Sara’s liver and knows there’s a risk his liver disease will return. He doesn’t drink and plans to return to the gym soon. ‘I owe it to Sara to last for as long as possible,’ he says. And Sara has never doubted her decision. ‘Yes, I have a scar – my bikini-wearing days are behind me – but I saved a life and have a new sense of purpose. That feels really good.’