Surgeons In the News
Transplant Services Team Up: First Combined Heart-Liver Transplant at NewYork-Presbyterian/Columbia
Michael Argenziano, MD |
Jean C. Emond, MD |
The first combined heart-liver transplant in the New York region was performed at NewYork-Presbyterian Hospital/Columbia University Medical Center on September 24, 2004.
Only a few such cases have been performed to date worldwide.
The procedure was made possible due to the combined expertise of the renowned Heart and Liver Transplant Programs at NewYork-Presbyterian/Columbia.
As many as 16 physicians, nursing professionals, and perfusion technicians were involved in the operation, which required extensive collaboration among teams specializing in pre-transplant treatment, transplantation surgery, and post-transplant care.
The surgical team included Drs. Michael Argenziano and David D'Alessandro for the heart, and
Drs. Jean Emond, Milan Kinkhabwala, and John Renz for the liver.
Prior to surgery, the patient had been under the joint care of Dr. Michael Schilsky, then Medical Director, Division of Abdominal Organ Transplantation at NewYork Weill Cornell Medical Center, and Dr. Donna Mancini, Medical Director of Heart Transplantation at NewYork-Presbyterian/Columbia.
Since the patient's liver and heart were both failing, neither transplant could be done alone.
The patient waited 128 days in the Cardiac Intensive Care Unit until a suitable donor with an appropriate liver and heart was identified.
Relying upon a single donor for both organs offers immunological advantages and decreases the chances of rejection for both organs.
The case was further complicated by the fact that the patient was highly sensitized and had antibodies against most potential donors.
In collaboration with the Heart Transplantation Immunology Service and Dr. Lloyd Ratner, Surgical Director of the Renal Transplant Program at NewYork-Presbyterian/Columbia, the two transplant teams were able to develop an innovative program to prepare the patient for receiving a transplant by removing antibodies with advanced medical treatment.
Due to the patient's debilitated condition, the patient required a week of intensive care following the transplant.
During that time, the patient's breathing was supported and nutrition was aggressively repleted. The patient is currently recovering at NewYork-Presbyterian/Columbia, under the care of expert transplant nurses, and overseen by joint care of the heart and liver transplant team.
This single achievement represents the most dramatic of a number of collaborative ventures in which advanced heart and liver disease have been treated jointly by these two respected transplant services.
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