University of Kentucky surgeons performed Kentucky's first combined heart-lung transplant in 15 years this summer, UK announced today. Dawn Nelson, 29, of Louisville, received two lungs and a heart from the same donor in one procedure at the Albert B. Chandler Medical Center on July 7. Combined heart-lung transplants are rare; only 27 were performed nationwide in 2011. They are generally performed on younger patients who have a fatal disease and cannot be treated with medication or other interventions.
Nelson was diagnosed with systemic lupus erythematosus at 17 and rheumatoid arthritis at 22. Four years ago, she also developed pulmonary hypertension, which is fatal without timely treatment. The disease destroyed her lungs, and her heart began to fail when it could no longer push blood into them.
Dr. Wesley McConnell, a transplant pulmonologist with Kentuckiana Pulmonary Associates in Louisville, began caring for Dawn two and a half years ago at their Pulmonary Hypertension Center. After her disease failed to respond to drug therapies, McConnell referred Dawn to UK May 11 for an inpatient transplant evaluation. "Dawn was extremely ill and it became clear that her only chance for survival would be a heart-lung transplant," he said. "I knew that UK was her best option because they had the most experienced team in the state."
Dr. Charles Hoopes, director of the UK Transplant Center, performed the surgery, only the seventh such procedure to be performed at UK since it began transplantation in 1964. The last time UK performed this surgery was 1996. "Although the surgery itself is relatively simple, combined heart-lung transplants are rare because they require three donor organs and are reserved for patients who are extremely ill with heart and lung failure," said Dr. Jay Zwischenberger, chair of the UK Department of Surgery. "They also require a great deal of infrastructure and support to perform successfully. At UK, we have that team in place, and moving forward we expect to perform one or two of these combined transplants per year."
More than four months after her surgery, Nelson continues to improve and grow stronger. Dr. Enrique Diaz, medical director for lung transplantation, and Dr. Navin Rajagopalan, medical director of cardiac transplantation, both provide followup care for her at UK, and she continues to see McConnell in Louisville. "Dawn is doing quite well. At the time of transplant, she was so sick she only weighed about 80 pounds," Rajagopalan said. "Now, she feels well, is gaining weight, and is able to do things that she had not been able to do for years.”
Nelson's collaborative treatment is a prime example of the partnership between Louisville and Lexington doctors that UK is trying to cultivate, said Dr. Michael Karpf, UK executive vice president for health affairs. “Our goal is to continue to provide highly advanced subspecialty care such as Ms. Nelson’s complex transplant to patients like her who otherwise would either have to leave the Commonwealth or worse, not receive the treatment needed,” Karpf said.
In November 2010, UK in collaboration with Norton HealthCare opened up an outreach Transplant and Specialty Clinic at Norton Audubon Hospital to provide comprehensive pre- and post-transplant care for patients. The partnership ensures that patients like Nelson will not have to leave the state to receive complex acute care or followup treatment, a UK press release said.