There were plenty of reasons to say no to performing a heart and liver transplant. For starters, it’s risky, and there aren’t enough organs. Oh yeah, and it’s never been done before in Ohio.
Rarely does a patient need both transplants at once, but the woman who received Ohio’s first dual heart and liver transplantation was lucky to be alive for the chance. She nearly died twice before the procedure; her heart was failing rapidly, and she had severe liver disease.
The 11-hour dual transplantation by the Cleveland Clinic’s Dr. Charles Miller, director of liver transplantation, and Dr. Nicholas Smedira, surgical director of the Kaufman Center for Heart Failure, Cardiac Transplantation and Mechanical Circulatory Support, involved at least 30 medical professionals in the operating room.
The doctors considered a laundry list of “ifs” before pursuing the double transplant. They needed the right donor and healthy organs. Then there were organ priority lists. This patient’s heart had greater priority than her liver, but doctors needed both at the same time to perform the transplant.
After months of waiting for the patient to be well enough to endure the lengthy operation, the doctors secured a heart and liver. Smedira transplanted the heart first, then Miller transplanted the liver.
“We have different instruments [for each procedure] and different nurses, and they were standing by, ready to do the dance and change places to get the new team in,” Miller explains. “Most centers would not want to do this.”