Washington University surgeons performed Barnes-Jewish Hospital’s first combined heart-kidney transplant June 2 and 3 on Jonathan Sadowski, 20, of O’Fallon, Mo.
The success of the procedure opens the door for other patients in the area with both heart and renal failure to have transplants, according to Gene Ridolfi, RN, Transplant Center director. Barnes-Jewish is currently the only hospital in the St. Louis region performing heart transplants. “Traditionally, patients with heart failure were disqualified as candidates for transplant if they also had renal failure,” said Ridolfi. “However, data show that for certain patients, like Jonathan, transplanting a donor kidney at the same time as the heart results in an increased chance of long-term survival.”
The transplant was performed in two stages, with Washington University heart transplant surgeon I-wen Wang, MD, PhD, performing the five-hour heart transplant in the evening on June 2.
Sadowski was then taken to the cardiothoracic surgery intensive care unit to be stabilized, and his new heart was monitored to make sure it functioned properly. During that time, a special pump cooled the donor kidney and continually flushed it with a preservation fluid to keep it in the best possible condition.
Several hours later, in the morning of June 3, Sadowski was wheeled back to the operating room where Washington University transplant surgeon Jason Wellen, MD, implanted the donor kidney in a four-hour operation. “The entire heart and kidney transplant was extremely successful,” Wellen said. “We’re very pleased with the outcome.”
The heart transplant was Sadowski’s second. He was born with left hypoplastic heart syndrome and received his first transplant in Virginia, when he was less than two months old. About a year ago, doctors found that he had developed transplant coronary artery disease, and anti-rejection medication plus his failing heart had caused irreversible damage to his kidneys.
While the failure of two organs might have automatically ruled him out as a candidate for transplant just a couple years ago, physicians now look at multi-organ transplants as an option for patients such as Sadowski— who is young, otherwise healthy and likely to benefit long term from the procedure, said Wellen. In addition, new anti-rejection medications and regimens have lowered the risk of patients developing organ damage or transplant coronary artery disease.
Only a handful of transplant centers across the country have the depth of specialized resources and personnel available to perform such a complex procedure and then provide ongoing care, said Wang.
“We’re lucky here at Washington University and Barnes-Jewish to have the resources and the multidisciplinary teams to do procedures such as this and then provide the long-term transplant care that results in outstanding outcomes,” he said.
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