This was to treat a patient with a rare form of appendix cancer. Upon completion of the lifesaving surgery, he received five digestive organs altogether, and at the same time!!!
This is a big deal.
The patient referred to Dr. Vaidya at Cleveland Clinic in 2021 previously had undergone surgical debulking of multiple intra-abdominal tumors, along with argon beam ablation, HIPEC, splenectomy, omentectomy, peritonectomy, cholecystectomy, appendectomy, biliary sphincterotomy and common bile duct stenting. Bulky disease remained at the hepatic hilum, epigastrium, pancreas, ascending colon, transverse colon, descending colon, sigmoid colon and rectum.
His tumor burden increased, with subsequent complications including portal vein thrombosis, gastric outlet obstruction, encasement of the duodenum, tumor incursion into the bladder, severe segmental narrowing of the proximal sigmoid colon, and bowel perforation with bacterial peritonitis and developing cholangitis. The patient was started on total parenteral nutrition and a gastrojejunostmy tube was placed for feeding and venting. Stents were placed in the duodenum and colon but developed perforations and abscesses.
At the time of referral, the patient was receiving hospice care.
“We needed to perform an evaluation to determine if transplantation in his case was safe, feasible and could provide long-term benefits,” Dr. Vaidya says.
Imaging showed that a tumor had encased the patient’s liver, compromising its blood supply. Had Dr. Vaidya seen the patient in his Oxford practice, that complication would have precluded a transplant, since UK organ procurement organizations resisted including a liver with the other donor organs for what was considered an experimental procedure.
In this case, the tumor affecting the patient’s liver was advanced but still contained within the abdominal cavity, with no sign of metastasis. The evaluation determined that a multivisceral transplant was justified. Dr. Vaidya received approval from Cleveland Clinic’s Intestinal Transplant Selection Committee to proceed and was able to place the patient on the national transplant wait list in mid-2021.
Compatible organs became available in September 2021. Immediately prior to surgery, the patient received induction therapy with the monoclonal antibody alemtuzumab to reduce the risk of acute rejection.
The multivisceral transplant took place over 17 hours and involved seven transplant, colorectal and urologic surgeons.
The donor organs — liver, stomach, pancreaticoduodenal complex, spleen, small intestine and right colon — were placed in the abdomen and their vascular inflow and outflow connections established. The multivisceral graft was reperfused and hemostasis was achieved.
The operation was the world’s first full multivisceral transplant to treat PMP.
For more detail see the link above. This warms my heart. When you have everything against you and you win. God Bless and thank you Cleveland Clinic for giving this man his life back. When he took the first bite of food, it brought a lot back. People don't realize how something so basic or "simple" is a celebration and a #WIN when you are that sick.
👇🏼
I regret some "tough love" I gave to my #Mom because I wanted her to eat because she was wasting. I didn't realize it then that she couldn't with cancer up to her #diaphragm and an average of 7 liters of #ascities every other day. 😓
See the attached link to see his discharge. This is great stuff.
