Unique Transplant Surgery Beats Cancer

Florida transplant surgeons announced the first successful
multi-organ transplant in which they temporarily took out all of the organs in
the abdomen of a 63-year-old South Florida woman with a rare type of cancer so they could remove the
tumor and its blood supply.

The surgical team discussed the 15-hour surgery at a news conference Monday
at the University of Miami/Jackson Medical Center in Florida.

"This is very brand new and unique approach," says Tomoaki Kato, MD,
the transplant surgeon who led the operation. "We have done a multi-organ
transplant before, but not in the same person. We have removed multiple organs
and then put them back in another person. It is very risky and definitely one
of the most challenging surgeries of my career."

But so far, so good.

The surgery took place three weeks ago. The patient, Brooke Zepp, is doing
"great," Kato tells WebMD. "She is considered cured at this point,
but only time will prove its long-term efficacy."

When Zepp watched a graphic video of the grueling surgery during the news
conference, she held back tears and said she couldn't believe it was her.

Vexing Tumor Location

The transplant surgery was so tricky because the tumor, called a
leiomyosarcoma, was located deep in the patient's abdomen and wrapped around
the aorta and the base of the celiac and superior-mesenteric arteries. These
arteries supply blood to the stomach, pancreas, liver, spleen, small intestine,
and much of the large intestine.

"If we tried to remove this tumor in the usual way, it would cause
damage to the organs supplied by all these arteries," Kato said at the news
conference. "This is considered inoperable using a usual surgical
approach."

There was literally no room to remove the tumor without damaging the organs.
Given six months to live and told that the tumor was inoperable by multiple
surgeons, Zepp underwent a combination of chemotherapy and radiation to kill
the cancer at other medical centers, but the treatments did not work.

Organs Put on Ice

"We took a very unusual approach and took everything out of the body
temporarily," Kato explains. "All the intra-abdominal organs and part
of the aorta were temporarily removed, chilled, and preserved outside the
patient's body."

Then, the tumor and the vessels were removed from the organs and placed in
an ice-cold basin.  "The blood vessels were then replaced with
artificial ones and all the organs were reimplanted in their normal
position."

This proved the most difficult part of the surgery, he tells WebMD.
"After removing the organs, we have to make sure that we will be able to
put them back in a good condition." No anti-rejection drugs are needed as the patient
is getting back the same organs that were removed.

This may be the tip of the iceberg, Kato says. "The new surgery may one
day benefit people with other tumors that are located in the same
area."

By Denise Mann
Reviewed by Louise Chang
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