Veteran receives dual heart-liver transplant
Michael Wilcher, a veteran of the U.S. Coast Guard, had idiopathic cardiac myopathy, a heart condition. Later learned he also had cirrhosis, which damaged his liver. His health worsened to the point where he needed both a heart transplant and liver transplant. That is a rare and unfortunate circumstance.
The second diagnosis “was like a damning,” said Wilcher, who was cured of hepatitis and stopped consuming alcohol in 2007. He still had lasting liver damage, however. “Even though I had stopped drinking, some things just followed me into a new life.”
He said his faith in God, support from his church and his determination to be a father for his then-14-year-old son kept him fighting for his life, even after medical centers in his network close to his home in Wilmington, Del., told him they couldn’t accept him as a patient for the double organ transplant. They did not have the expertise to do the procedure.
The VHA and VUMC worked together
Wilcher ended up at Vanderbilt University Medical Center through the Veterans Health Administration. He received a new heart and liver in a dramatic overnight surgery at Vanderbilt, one of only a handful of hospitals that performed this type of dual transplant surgery at the time. Only 29 combined heart-liver transplants occurred at U.S. hospitals in all of 2017, according to data from the Organ Procurement and Transplantation Network (OPTN).
“I am forever indebted,” Wilcher said. “The VA and Vanderbilt came in and stepped up to the plate just when we needed them the most.”
“We are also indebted to the family of the donor,” said his wife, Celeste Wilcher. “We appreciate them. We are grateful and we pray to God for their continued healing on the inside because they lost somebody important.”
Organ recovery teams flew from Nashville the night before the surgery to retrieve the heart and liver. They were back with the organs hours before sunrise. Wilcher was wheeled into an operating room at 1 a.m., awaiting their arrival.
“The organs arrived back by 2 a.m. or 2:30 a.m.,” said heart transplant surgeon Ashish Shah, M.D., professor of Cardiac Surgery. “We started the heart transplant first. That was done by 4:30 a.m. or so. We gave him a little bit of time to make sure the heart was working okay. Then the liver team started around 6 a.m. He was done and back in ICU by 11 a.m.” The same day as the surgery, Wilcher was up, eating breakfast and making a special request for oatmeal.
Months of preparation
Seth Karp, M.D., H. William Scott Jr. Professor of Surgery and director of the Vanderbilt Transplant Center, along with Sunil Geevarghese, M.D., MSCI, associate professor of Surgery, were Wilcher’s liver surgeons.
“These are complex patients that demand a lot from us as an institution, as a team and as individuals.”
This was not Vanderbilt’s first dual transplant but it was the first involving a liver and heart. The transplantation teams worked together for months preparing for the procedure.
“This is about orchestrating a complex operation, getting all the pieces to fit right, getting all the members on the team to work together and to make sure it is done thoughtfully and at an expert level,” Shah said. “These are complex patients that demand a lot from us as an institution, as a team and as individuals. So, there was a lot of planning that went into proceeding with this. All this planning paid off.”
Wilcher is appreciative of all that preparation. “My wife and I are so grateful,” Wilcher said, “and thankful for Vanderbilt being willing to take on a risky operation.”
By 2019, VUMC was tied for the most heart transplants performed per year anywhere in the United States; and it performs more heart transplants than any other program in the Southeast.
Vanderbilt is also among the top hospitals in the United States performing liver transplants, according to a report published in the American Journal of Transplantation. Vanderbilt performed 128 adult liver transplants between July 2017 and June 2018, according to the Scientific Registry of Transplant Recipients.
- Hepatobiliary and Liver Surgery, Kidney and Pancreas Transplant, Liver Transplant, Liver Transplantation, Pediatric Kidney Transplant, Pediatric Liver Transplant, Renal Transplantation
- Benign and Malignant Diseases of the Liver, Gallbladder, and Bile Ducts, Biliary Disease / Gallbladder, Cancer, Gastroenterology Surgery, Gastrointestinal, General Surgery, Hepatobiliary Cancer Surgery