Mayo Clinic team performs first Jacksonville lung transplant

Tuesday, June 12, 2001

JACKSONVILLE, Fla., June 12, 2001 — In the early morning hours of June 7, a Mayo Clinic transplant team at St. Luke's Hospital successfully performed Jacksonville's first lung transplant.

Hours earlier, the Mayo transplant team retrieved the lungs, the heart and the liver from a donor. The donor organs made it possible for Mayo transplant teams to simultaneously perform the double lung, heart and liver transplants in three individuals. The historic event underscores the position of Mayo Clinic and St. Luke's Hospital as a major tertiary care center.

Dr. Octavio Pajaro, surgical director of the lung transplant patient, retrieved the donor heart and lungs and also implanted the lungs in the recipient. "We offered this young patient two lungs instead of a less difficult single lung transplant," Pajaro said. "In his case it would improve his long-term outcome. This is the start of what we anticipate will be a strong and busy program. The multiple, simultaneous transplants performed emphasize the strength of our team."

Mayo Clinic's bone marrow, liver, kidney, pancreas, heart and lung transplant programs are supported by more than 200 people including surgeons and other physicians, nurses, technicians, social workers and support staff.

The double lung recipient, a 48-year-old man from Melbourne, Fla., suffered from silicosis and pulmonary fibrosis. His disease was likely caused by years of exposure to silica while working as a sandblaster.

Mayo Clinic pulmonologist and medical director of lung transplantation, Dr. Cesar Keller, says his patient's only option was a transplant. "His lungs were destroyed by the deposition of silica." Keller says. "This had produced silicosis and fibrosis. There's no medication that can remove that from the lungs. These patients tend to have progressive, relentless respiratory failure."

The disease caused adhesions to develop between the patient's lungs and the chest wall. They were essentially stuck together. The delicate procedure to remove the diseased lungs took hours. Cardiothoracic surgeon Dr. John Odell worked to free first the left and then the right lung. "There's a lot of reaction and scar formation around the silica," Odell says. "You could feel these hard masses in the lungs. Whenever we tried to retract the left lung to free the adhesions, we were pressing what felt like a brick against the heart. That dropped the blood pressure and his oxygenation. We only had short periods of time in which to work before we had to stop and wait for his heart to recover."

Odell says silicosis is not a common indication for lung transplantation in this country. That's because those with years of exposure to the damaging silica dust, before the enactment of tougher workplace regulations, are usually older and not fit candidates for a transplant.

Keller says his patient's relatively young age and overall fitness made him a good candidate for the surgery. "He's physically strong, well nourished, and other than his lungs, all his other organs were working perfectly," Keller says. "The surgery was technically complex, but his prognosis is very good."

Doctors say the prognosis is also good for the two other transplant patients. A 65-year-old woman from Severn, Md., received a new liver, and a 52-year-old man from Saraland, Ala., received a new heart.

Media contact: Erik Kaldor 904-953-2299 kaldor.erik@mayo.edu

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