TransplantWords
--One Man, Six Organs: Georgetown Transplant Patient Goes Home--
Greg Marshall is “dying for a sausage.” His digestive organs stopped working 2 years ago, and ever since, the 43 year old New York native has been fed intravenously. But solid foods will soon again be in his diet; on August 25th, Marshall underwent a rare 14-hour transplant surgery at Georgetown University Hospital. Last month, just three weeks after the operation, he walked out with a functional digestive tract. And six new organs.
"It's exceptional that we're able to take six organs and replace them and actually make them work," said Thomas Fishbein, head surgeon for Marshall’s transplant surgery.
Marshall had received a liver, kidney, pancreas, stomach, small bowel, and colon. Only 20 such transplants have been performed in the United States, according to the United Network for Organ Sharing. And not all of these transplants involved six organs. Because the intestine includes the small bowel, the colon, and the stomach, other surgeries categorized as “liver-kidney-pancreas and intestine” transplants may have only involved replacement of 1 or 2 of these three intestinal organs. In Marshall's case, all three were replaced. Doctors also replaced many of his immune cells in an effort to prevent his body from rejecting the transplants.
And today, several weeks later, he’s feeling just fine. “He’s got that twinkle back in his eye,” his wife told reporters. Before the transplant, Marshall had suffered from Gardner Syndrome, a rare immune disorder caused by a defect in the APC (adenomatous polyposis coli) gene. In America, only one person in one million is diagnosed with Gardner Syndrome each year. Characterized by abnormal production of polyps and tumors in the intestine, it ultimately results in organ failure, and makes digestion nearly impossible. Furthermore, it is inherited in an autosomal dominant pattern; if Mom has it, there’s a 50% chance that you will, too. In fact, Marshall’s mother does have the disease, and so does his sister. But neither of them had ever experienced a complete immune shutdown, like Marshall had before the surgery, when he was confined to the couch by his intravenous feeding tube.
In hopes of ending Marshall’s battle, Dr. Fishbein replaced his intestinal organs (stomach, small bowel, colon), and he also replaced his liver, kidney, and pancreas. Marshall needed replacements for these last three organs due to scarring left over from a 1997 operation. That year, his stomach had protruded oddly from his lean frame, and curious doctors located a basketball-sized tumor in his abdomen. Removing it meant that he’d need a bowel transplant, but Marshall’s body rejected the organ, resulting in so much scarring in his digestive system that his other organs began to stop working, too.
After that, Marshall waited several years for a new set of organs. In multiple organ transplants, patients can be given organs from multiple donors, but doctors at Georgetown prefer that all organs come from one donor. “When we get to these sort of numbers more than four... five, six organ transplants in a single setting, it works much better if we are able to have the organs attached to one another," Dr. Fishbein explained. Naturally, the number of available donors is low.
“I didn’t believe it was ever going to happen,” Marshall said. Then, last August, doctors phoned to inform him that a donor with six compatible organs had indeed become available. Marshall would be getting a multiple-organ transplant the following day.
“I was happy for us, but sad for the people who had lost someone,” said Marshall’s 16 year old son, Brandon, referring to the donor’s family. Brandon also acknowledged how lucky his father is; many people “are still waiting for organs.” The telephone call was clearly a relief for the family. For a year, the intravenous line that fed him had limited Marshall’s movements. He’d rarely been able to leave the couch, and he’s never gotten to play with his 18 month old granddaughter. “I’m looking forward to spending time with her,” Marshall says now, after the surgery.
For the time being, he’s staying in a hotel near Georgetown University Hospital so that his progress can be monitored. Because of careful precautions (i.e. organs from just one donor, replacement of immune cells), there is little chance that Marshall’s body will reject the transplanted organs. However, it is always a possibility, and rejection usually occurs within the first three months. According to his family though, Marshall is “in good spirits” and among other things, he looks forward to soon eating his first real meal.
.MGW.
Greg Marshall is “dying for a sausage.” His digestive organs stopped working 2 years ago, and ever since, the 43 year old New York native has been fed intravenously. But solid foods will soon again be in his diet; on August 25th, Marshall underwent a rare 14-hour transplant surgery at Georgetown University Hospital. Last month, just three weeks after the operation, he walked out with a functional digestive tract. And six new organs.
"It's exceptional that we're able to take six organs and replace them and actually make them work," said Thomas Fishbein, head surgeon for Marshall’s transplant surgery.
Marshall had received a liver, kidney, pancreas, stomach, small bowel, and colon. Only 20 such transplants have been performed in the United States, according to the United Network for Organ Sharing. And not all of these transplants involved six organs. Because the intestine includes the small bowel, the colon, and the stomach, other surgeries categorized as “liver-kidney-pancreas and intestine” transplants may have only involved replacement of 1 or 2 of these three intestinal organs. In Marshall's case, all three were replaced. Doctors also replaced many of his immune cells in an effort to prevent his body from rejecting the transplants.
And today, several weeks later, he’s feeling just fine. “He’s got that twinkle back in his eye,” his wife told reporters. Before the transplant, Marshall had suffered from Gardner Syndrome, a rare immune disorder caused by a defect in the APC (adenomatous polyposis coli) gene. In America, only one person in one million is diagnosed with Gardner Syndrome each year. Characterized by abnormal production of polyps and tumors in the intestine, it ultimately results in organ failure, and makes digestion nearly impossible. Furthermore, it is inherited in an autosomal dominant pattern; if Mom has it, there’s a 50% chance that you will, too. In fact, Marshall’s mother does have the disease, and so does his sister. But neither of them had ever experienced a complete immune shutdown, like Marshall had before the surgery, when he was confined to the couch by his intravenous feeding tube.
In hopes of ending Marshall’s battle, Dr. Fishbein replaced his intestinal organs (stomach, small bowel, colon), and he also replaced his liver, kidney, and pancreas. Marshall needed replacements for these last three organs due to scarring left over from a 1997 operation. That year, his stomach had protruded oddly from his lean frame, and curious doctors located a basketball-sized tumor in his abdomen. Removing it meant that he’d need a bowel transplant, but Marshall’s body rejected the organ, resulting in so much scarring in his digestive system that his other organs began to stop working, too.
After that, Marshall waited several years for a new set of organs. In multiple organ transplants, patients can be given organs from multiple donors, but doctors at Georgetown prefer that all organs come from one donor. “When we get to these sort of numbers more than four... five, six organ transplants in a single setting, it works much better if we are able to have the organs attached to one another," Dr. Fishbein explained. Naturally, the number of available donors is low.
“I didn’t believe it was ever going to happen,” Marshall said. Then, last August, doctors phoned to inform him that a donor with six compatible organs had indeed become available. Marshall would be getting a multiple-organ transplant the following day.
“I was happy for us, but sad for the people who had lost someone,” said Marshall’s 16 year old son, Brandon, referring to the donor’s family. Brandon also acknowledged how lucky his father is; many people “are still waiting for organs.” The telephone call was clearly a relief for the family. For a year, the intravenous line that fed him had limited Marshall’s movements. He’d rarely been able to leave the couch, and he’s never gotten to play with his 18 month old granddaughter. “I’m looking forward to spending time with her,” Marshall says now, after the surgery.
For the time being, he’s staying in a hotel near Georgetown University Hospital so that his progress can be monitored. Because of careful precautions (i.e. organs from just one donor, replacement of immune cells), there is little chance that Marshall’s body will reject the transplanted organs. However, it is always a possibility, and rejection usually occurs within the first three months. According to his family though, Marshall is “in good spirits” and among other things, he looks forward to soon eating his first real meal.
.MGW.
posted by Meagan G at
12:34 PM
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