It is a little past nine in the morning, and Silas has just woken up in his apartment in Køge after yet another night in which he has been unable to find rest. In the living room, the morning light hits a small LEGO light rail train parked on the windowsill. Just below it rests a lonely grey Under Armour backpack against the radiator. It does not contain much yet, but the plan is that it will one day be packed with a set of clothes, sweatpants, a computer, two pairs of headphones, a power bank, and an extra charger. Maybe also Churchill’s biography. Just enough for Silas to get by for a while when he has to put his life on hold at short notice.
“Your body knows it. You can’t put it away. It is so deeply ingrained in you that the call will come at some point. You just don’t know when.”
Twenty-seven-year-old Silas Thing Sørensen is one of approximately 24 Danes currently active on the waiting list to receive a new liver.
Silas was born with an underdeveloped liver as a result of Alagille syndrome; a rare condition that causes missing or underdeveloped bile ducts in the liver. He was therefore only three years old when he underwent his first liver transplant.
A few years later, his condition worsened, and in the middle of second grade he underwent another liver transplant. It failed and caused a blood clot in the liver’s main artery, and a few days later he received his third liver.
A few years later, his condition worsened, and in the middle of second grade he underwent another liver transplant. It failed and caused a blood clot in the liver’s main artery, and a few days later he received his third liver.
It has been more than 18 years since Silas last underwent a liver transplant. Despite difficult periods with liver infections and short hospital admissions, he has been well. Now early signs of cirrhosis have sent him back onto the waiting list, where he has spent the last nine months waiting for the call that a fourth liver is available.
Does God want me to have four liver transplants?
Silas has held death in his hands for most of his life, but he has always approached both life and death in a very pragmatic way. When it became clear that his third liver would not last much longer, he spoke with a hospital chaplain about his future. Not because he is religious, or because he sought comfort in belief in something greater, but because he needed help identifying what makes life worth fighting for a fourth time.
“I find it difficult to believe in God when you have to undergo a liver transplant four times. You could of course say that it is God’s way of testing me. But does God want me to have four liver transplants? Then he is kind of an asshole.”
As long as Silas is on the waiting list, his phone is always fully charged and within reach. He is not allowed to leave the country or visit islands without bridge connections, and he must also notify Rigshospitalet if he travels to Funen or Jutland.
Silas is happy with his life, but he is currently living in a state of suspension. A life whose continuation depends on the death of others.
“The world keeps moving, but my life is on hold. Nothing really changes.”
By the end of 2025, just under 400 Danes were on the waiting list for a new organ. For them, organ donation is not an abstract issue, but a daily reality. They live in bodies that are slowly failing, while hoping for the call that could extend their lives. On the surface, their everyday lives may look like anyone else’s, but they live in a constant state of readiness—always available, always prepared to put their lives on hold, with no guarantee that they will ever be able to resume them.
Between Transplants
It hasn't been long since Silas got out of bed. He enters the bathroom, takes a syringe from one of the neatly organized boxes on the shelf above the toilet, and sits down on the toilet seat with his trousers pulled down to his knees. The syringe contains blood-thinning medication that is meant to prevent blood clots in the transplanted liver.
It stings in his thigh as Silas pushes the plunger all the way down, but there is not even a hint of a grimace on his face. It is routine.
After breakfast, he takes more medication. Something that protects the liver against infection. Something that prevents the immune system from rejecting the transplanted liver. Something that prevents the buildup of substances from the liver. Something for the intense itching caused by this buildup. Something for fluid accumulation outside the liver. And something that regulates blood sugar and strengthens the bones.
Several of the preparations must be taken again throughout the rest of the day.
Four liver retransplantations are extremely rare, and there is therefore no existing data that can provide a statistical insight into Silas’ chances of surviving his upcoming liver transplant. However, it is known that survival rates decrease with each transplantation.
“When I have first told myself that I have to go through it, I stick with that. I do think that, hopefully, it will get better. This liver cannot keep going, so I have to do something active to make life better. I have to take that chance. But I am prepared for the fact that I will most likely die on this one. I am being realistic.”
In the summer of 2025, Denmark’s organ donation consent law was changed to a soft opt-out system. This means that one still has to actively confirm one’s donor status for it to be valid. The legislative change led to a significant increase in registrations in the organ donor register, but every third Dane has still not taken a position on organ donation. The most underrepresented group is young people. Studies suggest that many young people find it difficult to confront their own mortality and therefore postpone the decision.
Underneath the T-shirt
Silas is not allowed to get tattoos, as his immunosuppressive medication makes him more vulnerable to infections. Instead, his body is marked for life by a large scar, a constant reminder of the – so far – three foreign livers that have given him his life back.
Silas is not allowed to get tattoos, as his immunosuppressive medication makes him more vulnerable to infections. Instead, his body is marked for life by a large scar, a constant reminder of the – so far – three foreign livers that have given him his life back.
At the same time, Silas feels that the scar becomes an unsolicited invitation to other people’s imaginative guesses about what he has been through, and therefore he rarely shows his upper body. When he covers the scar, he feels like he looks like everyone else.
“When I show my body, people can already see half my story before I’ve even had the chance to tell it.”
A few months ago, he bought a silver necklace with a pendant shaped like an eagle. To Silas, it symbolizes strength and endurance.
About every other day, when the clock strikes 8:30 p.m., Silas goes to the gym to train and keep himself in the best possible shape. It may increase his chances of survival when the day finally comes. At the same time, being in good physical condition can help him get back on his feet more quickly and makes him more resilient to complications. He is also trying to gain weight, knowing that he will lose a significant amount during the transplant process.
“When you’re getting a new liver, you take two steps forward and five steps back.”
Without Disturbance
A muted click breaks the silence in the small driver’s cab as Silas instinctively presses the deadman’s handle every few seconds. When too much time passes between the clicks, the rhythm is interrupted by a short warning signal. It is the deadman’s function, requiring a sign of life from Silas every ten seconds.
A muted click breaks the silence in the small driver’s cab as Silas instinctively presses the deadman’s handle every few seconds. When too much time passes between the clicks, the rhythm is interrupted by a short warning signal. It is the deadman’s function, requiring a sign of life from Silas every ten seconds.
He brakes at Ishøj Station, turns the key, unlocks the narrow glass door, and walks purposefully through the three carriages. At the end, he locks himself into the other driver’s cab, turns the key again, and drives in the opposite direction towards Rødovre Nord Station, accompanied by the steady, muted signs of life.
As a child, when Silas was admitted to Rigshospitalet, he would always go out riding S-trains with his grandmother during breaks between examinations. Ever since, trains have been one of his great passions. Two years ago, he was employed at the light rail control centre Metro Service in Glostrup, where he works, among other things, as a light rail driver.
“I think I love this job because it is so simple. As a liver transplant patient, so many things are constantly happening in my life that create unrest. When I am driving, there is no unrest around me. It is just what it is. Completely normal.”
Silas hopes that the next liver will give him enough stability in life that he will one day be able to work in project management.
A World of Its Own
Rigshospitalet is the only hospital in Denmark that performs liver transplants, and it has therefore formed the framework for much of Silas’ life. He has almost grown up there, celebrating birthdays, Christmas, and completing more than a year of his schooling there. He knows the building, the staff, and its rhythm. It is where he feels safest. But when half of your life has revolved around Rigshospitalet, it can be difficult to figure out who you really are as a person in the outside world.
Rigshospitalet is the only hospital in Denmark that performs liver transplants, and it has therefore formed the framework for much of Silas’ life. He has almost grown up there, celebrating birthdays, Christmas, and completing more than a year of his schooling there. He knows the building, the staff, and its rhythm. It is where he feels safest. But when half of your life has revolved around Rigshospitalet, it can be difficult to figure out who you really are as a person in the outside world.
“Hospital is a world of its own. Here, everyone wants what is best for you. You know what you are walking into, and how people are. They will always try to do what is best for you. It is not necessarily like that when you step out into the real world. I had to learn how to be social. Sometimes I still struggle with that.”
Although Silas feels that people generally understand his illness, many do not understand how little energy he actually has. He gets tired quickly and needs breaks. Because of this, online gaming has become a way for him to be social on his own terms when he is not hospitalized. Here, he can step away for an hour or two without anyone questioning his sudden absence.
While Silas is on the waiting list for an organ transplant, he attends check-ups at Rigshospitalet every three months. Here, both his mental condition and physical health are assessed so that doctors can evaluate his ability to undergo the upcoming liver transplant.
“I just try to focus on working out, my job, and whatever makes me happy. I think it might improve my chances of getting through it.”
Silas and Andrea at Holtug Chalk Pit, a few hundred meters from the family’s country property in Holtug. The chalk pit is part of the Stevns Klint hiking trail – a route of approximately 20 kilometres, which Silas used to walk once a year when he lived with his mother.
The Two of Us
Silas can feel behind in life when he sees his peers starting families and settling down. He wants to find someone to share his life with, but it is difficult to plan a future when life is on standby and may soon be put on hold indefinitely.
Silas can feel behind in life when he sees his peers starting families and settling down. He wants to find someone to share his life with, but it is difficult to plan a future when life is on standby and may soon be put on hold indefinitely.
“How do you even start a conversation with a potential girlfriend about the fact that you have had a liver transplant? At the same time, she has to be prepared for the fact that there is a high risk that I will die during the operation.”
In the meantime, he divides his social energy between work and family. His illness has placed family at the top of his list of priorities. It is important for him to have them close – especially during periods when he cannot manage on his own. Silas’ entire family lives in the Køge area, and once a week he visits his mother, her partner, and his younger sister Andrea, 12, at the family country property a short distance from Holtug Chalk Pit.
“I have been thinking more about how I spend time with my family while I am on the list. I do not know what the outcome will be, or when I will get that call.”
MRI scan of Silas in March 2019. On the left, the metal stent inserted into Silas’s fourth and current liver is visible. The stent holds the bile duct open from the inside, allowing bile to flow normally into the intestine.
When Silas underwent his second and third liver transplants, he came close to dying. It took him four years to fully recover and return to a relatively normal everyday life. He was therefore initially in doubt about whether it was all worth it when he was told that he would need a fourth transplant.
But his desire to see his younger sister grow up became a decisive factor for Silas.
“There was a risk that I would die before she is confirmed. I would like to see her finish primary school, complete high school, and maybe start university – whatever she chooses. When our parents are no longer here, it will just be the two of us.”
In Silas’ kitchen hangs a white oven mitt with a drawing of a light rail train similar to the one Silas drives from Rødovre Nord to Ishøj and back again. Beneath the drawing, Andrea’s handwritten text nearly spills over the lower edge of the oven mitt:
Translation: Silas T. S. best big brother
Silas dreams, above all, of a normal life. Of getting a liver that will last the rest of his life and keep him alive at least until he turns 60.
“Then I could be more present for my little sister and for others. Help others instead of always needing help myself.”
