Rare double transplant performed at St. Paul's Hospital
Thursday, August 29, 2013, Vancouver BC – Recently, doctors at St. Paul’s Hospital (SPH) performed a rare double transplant (heart and kidney) on the same patient, with both organs coming from a single donor. Spanning 14 hours and involving two surgeon specialists and a team of professionals, this was only the fifth time this type of double transplant has taken place in British Columbia.
“A transplant is already major surgery and receiving two organs increases the risk considerably,” said Dr. Jamil Bashir, Cardiac Transplant Surgeon at SPH. “This is truly a team effort. The procedures involve a lot of decision making and a massive team of people working together to ensure that it will be successful.”
Rob Nutter, a 55-year old millwright from Castlegar, was walking just days after receiving the two organs and his recovery has continued unabated.
“It was incredible that I woke up, and my wife and my sister were with me and they said ‘Rob, you made it, you’re alive’. And I couldn’t talk because I had tubes in my mouth and I had tears in my eyes,” said Nutter. “You somehow think you’re not going to make it and they just kept saying ‘Rob, you made it, you’re done’.”
The procedure begins with the cardiac surgeon performing the first transplant. In Nutter’s case this took approximately seven hours. The cardiac surgeon must then determine if the patient is well enough to undergo the second transplant, which can take just as long as the first.
“Performing a kidney transplant after the patient has just received a heart transplant is exceedingly complex. You have to care for and constantly monitor the state of the new organ while performing what is already an intricate procedure,” said Dr. Michael Eng, Renal Transplant Surgeon and Urologist at SPH.
Nutter’s double transplant came after years of health issues beginning in 1998 when he was diagnosed with presumed post-viral dilated cardiomyopathy. In 2012, doctors at SPH implanted a ventricular assist device in Nutter’s heart, to maintain his condition while waiting for transplant. In addition to his heart issues, he also experienced renal failure requiring kidney dialysis.
Doctors considered performing the surgeries separately, but worldwide statistics show improved outcomes if the patient receives both organs from the same donor. The stability of the patient is also a key concern. Cardiac experts together with the renal transplant team determine whether to wait for one donor for both organs.
“This incredible story is possible because one family, during a time of unimaginable tragedy, made the decision for their loved one to be an organ donor. I’m certain the family would take comfort in seeing that their gift of life has made such a remarkable difference,” said Dr. Greg Grant, Provincial Executive Director, BC Transplant.
The immediate path to recovery for Nutter involves constant assessment and analysis by clinic staff and doctors at SPH. As part of his recovery, Nutter is taking three-hour walks along Vancouver’s seawall. He has not needed dialysis since the surgery. He wants to share his story to inspire others who might be in similar situations and to raise awareness for organ donation.
Register online to be an organ donor at transplant.bc.ca.
Providence Health Care (PHC) is one of Canada's largest faith-based health care organizations, operating 16 health care facilities in Greater Vancouver. PHC operates one of two adult academic health science centres in the province, performs cutting-edge research in more than 30 clinical specialties, and focuses its services on six “populations of emphasis”: cardio-pulmonary risks and illnesses, HIV/AIDS, mental health, renal risks and illness, specialized needs in aging and urban health and is home to the B.C. Centre for Excellence in HIV/AIDS.
BC Transplant provides provincial oversight for all aspects or organ donation and transplantation in BC, and is an agency of the Provincial Health Services Authority. BC’s three transplant centres are BC Children’s Hospital (pediatric kidney and liver), St Paul’s (heart and kidney) and Vancouver General Hospital (kidney,liver, lungs, pancreas/islet). Transplant patients receive follow up care at the transplant centres or at one of seven regional clinics close to their home community.
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Ken, cardiac patient