Houston VA performs first Multi-Organ Transplant involving the Heart
In July, Air Force Veteran Walter Pinkney was the recipient of a simultaneous heart and kidney transplant at the Michael E. DeBakey VA Medical Center in Houston, a groundbreaking multi-organ transplant surgery.
Houston VA performed its first heart transplant in January 2023 and has performed simultaneous liver/kidney transplants since 2014. But this was the first time Houston VA has added the heart in a multi-organ transplant.
“In 1983, I was diagnosed with heart problems and discharged (from the Air Force),” said Pinkney, who served from 1980 to 1984. “I had a lot of problems throughout the years and was diagnosed with congestive heart failure in 2014. I had to have a pacemaker and defibrillator put in. In 2021, I had a stroke and it started bringing me down and my doctors decided that they wanted to consider a heart transplant.”
Unfortunately, heart issues can have a negative impact on the kidneys.
“Anytime there are changes in the hemodynamics (blood flow) of the body, and if they're sustained for too long, that can injure the kidneys,” said Dr. Nidhi Aggarwal, transplant nephrologist and medical director of the Houston VA kidney transplant program.
Without a new kidney, one of the possibilities for Mr. Pinkney was a future dependency on dialysis.
“That can lead to a reduced life expectancy, even after a heart transplant,” said Dr. Aggarwal. “So that is why the decision was made to list him for both a heart and kidney transplant at the same time.”
With three successful heart transplants, Houston VA demonstrated the capability to perform the heart-kidney transplant.
“When we evaluated Mr. Pinkney, it became clear he needed a heart-kidney transplant,” said Dr. Savitri Fedson, medical director of the heart transplant program. “We wanted to make sure he got all the treatment he needed within VA.”
Dr. Alexis Shafii, Baylor St. Luke’s Surgical Director, Heart Transplantation and Baylor College of Medicine Associate Professor of Surgery, Cardiothoracic Transplant & Circulatory Support, served as the lead for the heart transplant, while Dr. Ron Cotton, Houston VA surgical director and transplant surgeon, served as the lead for the kidney transplant.
Dr. Venkat Ramanathan, director of the Houston VA Transplant Center, said he was proud of everyone involved.
“A heart transplant by itself is a complex procedure,” said Dr. Ramanathan. “Then to go on and do two simultaneous transplants, it’s a big deal. From doctors coordinating care, transplant coordinators and everyone else involved, it takes almost double the village to make a multi-organ transplant work. There's a lot of coordination that happens.”
Mr. Pinkney is beyond grateful to receive the organs and to the transplant center for making it possible.
“The heart transplant and kidney transplant teams here at the hospital have been stupendous with what they’ve done for me,” he said. “These people have bent over backwards to take care of me and get what I need. I believe this is the best staff in the whole VA (system).”