Multi-Organ Autotransplantation
Nancy Heim
A lemon-sized tumor, attached to a patient's main arteries and wedged behind several or gans, was considered inoperable by other institutions.
At NewYork-Presbyterian Hospital/Columbia, surgeons successfully removed the patient's liver, pancreas, spleen, stomach, small intestine, and two-thirds of the large intestine.
After excising the tumor safely, the team reconstructed the blood vessels and performed auto-transplantation to reattach the patient's organs.
In the past, surgical removal was not an option for some deeply embedded tumors involving the abdominal blood vessels. Now, transplant surgeons at NewYork-Presbyterian Hospital/Columbia University Medical Center (NYPH/Columbia) have developed a way to use a surgical method called autotransplantation to remove these otherwise inoperable tumors.
"Tumors involving the abdominal blood vessels have been considered inoperable because removing the tumor would cut the blood supply to vital organs," says Tomoaki Kato, MD, Surgical Director, Liver and Gastrointestinal Transplantation.
Autotransplantation is the removal and reimplantation of a patient's own organ (or organs). Unlike patients who receive organs from donors, patients undergoing autotransplantation do not have to wait for a donor to become available. They are not required to take immunosuppressant medications following surgery, as is the case with transplantation of donor organs.
The state-of-the-art autotansplantation technique builds upon NYPH/Columbia’s successes with multi-organ transplantation, most commonly used to treat patients with liver and intestinal failure. This year, Dr. Kato and a team of seven surgeons removed the small and large intestines, liver, pancreas, spleen and stomach from a seven-year-old girl. Three separate surgical teams worked to excise a tennis ball-sized tumor that was tangled among her vital abdominal organs and essential blood vessels. After removing the tumor, the team re-implanted the liver as well as the small and large intestines. The girl's pancreas, spleen and stomach — organs that had been compromised by the tumor — were unsuitable for reimplantation and could not be re-implanted. While the patient's life is no longer in danger, she will have some longterm medical challenges. With her large intestine taking over the work of her stomach, she will have dietary restrictions comparable to that of someone who has had gastric bypass surgery. Without a pancreas, she will be diabetic. Absence of a spleen will possibly make her more susceptible to certain infections.
NewYork-Presbyterian Hospital is one of the few centers in the world with the expertise to perform multi-organ transplantation and autotransplantation.