 Staff gathered to wish happy birthday and farewell to patient Fletcher Blevins (seated) on the day of his discharge from NBIMC. The 62-year-old Newark resident was the second patient to undergo a simultaneous heart and kidney transplant at NBIMC. Standing behind Mr. Blevins are (from left) Luis Arroyo, M.D., transplant cardiologist; Patricia Skerko, M.S.W., social worker in cardiac transplantation; Carmen Flores, R.N.C., renal transplant coordinator; and Sandi Bausback-Aballo, R.N., C.C.T.C., cardiac transplant coordinator. Mr. Blevins’s combined transplant procedure was performed by Laszlo Fuzesi, M.D., and Scott Ames, M.D.
Since 1990, multiple developments in the field of transplantation have allowed transplant teams to consider patients with serious, challenging medical problems for transplantation. Prior to this time, a patient with advanced heart disease combined with advanced kidney failure would not be considered for any type of transplantation. Today, however, NBIMC offers patients with such challenging conditions a combined heart/kidney transplant procedure. This service extends to former successful transplant patients. A patient who has undergone a successful heart transplant and later develops kidney failure may now be considered for a kidney transplant.
The simultaneous heart/kidney transplant procedure is unique and quite intensive. It requires considerable organization and communication between two separate transplant teams. At NBIMC, two such transplants have already been performed, and several more patients are in the process of being evaluated. To date, both patients have done extremely well with excellent functioning of their hearts and normal kidney function, as well. These patients would have otherwise required long-term dialysis treatments.
Other simultaneous organ transplants, such as simultaneous pancreas/kidney transplantation, are becoming commonplace. Simultaneous pancreas/kidney transplantation is offered at SBMC for patients with insulin-dependent diabetes who fulfill certain medical criteria.
The aggressive follow-up that is required and subsequent rehabilitation of these patients is somewhat different than a single organ transplant procedure. For example, the length of hospitalization is often twice as long as with a single transplant, and the time required for complete physical recuperation following surgery also doubles. Additionally, patients require different immunosuppression protocols that may lead to more complicated hospitalizations as well as repeat admissions for such things as infections or rejection episodes.
No doubt, the stress associated with simultaneous transplantation is likely to be more intense, particularly given the life-threatening nature of some procedures, such as heart transplantation. Because of the SBHCS commitment to complete patient satisfaction and rehabilitation, staff members are dedicated to helping each patient and family cope with the challenges outlined above. One example of SBMC’s proactive approach to patient education is the creation of a unique bi-monthly support group for recipients of simultaneous pancreas/kidney transplants and their families.
Despite the limitations imposed by the extraordinary circumstances of simultaneous transplantation, successful rehabilitation may be achieved with three basic ingredients: the efforts of a highly motivated patient, the support of a loving family, and a dedicated transplant team that is committed to helping each patient achieve the highest level of functioning.
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