Banding together for Dan.
Making a New Diagnosis
It didn’t take long after Dan’s first visit before it became clear that Dan’s condition involved two organs rather than just one. He met with Cardiologist Kambiz Ghafourian, MD, MPH, and was admitted to Northwestern Memorial Hospital three days later. The rush stemmed from a battery of tests that revealed a new discovery: Dan’s liver was at the root of his heart trouble.
Dan’s condition also resulted in cirrhosis, or scarring of the liver. That was a big red flag. If he were to undergo a heart transplant alone, the liver would be also be at risk. Without both procedures, Dan could have died.
Through extensive genetic testing, Dr. Ghafourian concluded that Dan was suffering from amyloidosis, a rare disease in which the liver produces a protein that builds up in the heart. Following the diagnosis, Transplant Hepatologist Lisa B. VanWagner, MD, MSc, and the hepatology team confirmed scarring in the liver. With Dan dangerously approaching double organ failure, the cardiology team and the hepatology team conferred with the heart transplant surgery and the liver transplant surgery team, and it was determined that Dan would need a dual transplantation: heart and liver.
It Took A Team of 200
Dan spent four months in the hospital awaiting his new heart and liver. During that time, more than 200 staff members played a role in his care.
They took care of everything for me. From anxiety to physical therapy to occupational therapy, a dietitian, everything I needed physically and mentally was done beautifully by Northwestern Medicine.
Finally, on his 100th night at Northwestern Memorial Hospital, Dan received a 3 a.m. wake-up call from a team physician. The voice on the other line said, “Look out in the hallway.” Standing there were Dan’s surgical team and his wife. It was time.
Two transplants in one day.
As part of the top-ranked Cardiology and Heart Surgery program in Illinois, among the top 10 in the nation,* Dr. Ghafourian had guided Dan’s initial prognosis. Once organs became available, Dr. Ghafourian guided his team through an evaluation of Dan’s future heart.
I just hit it off with Dr. Ghafourian. To me, next to my father, he’s the greatest man I’ve ever known. He saved my life.
*Northwestern Memorial Hospital, U.S. News & World Report, 2020 – 2021
With Dan’s future heart secured, it was up to Dr. VanWagner to identify a liver that would also take. Complicating matters was the need to craft a medical regimen that would allow both organs to do well and not to be rejected.
We had two dozen meetings to review our medical protocols, what kind of medications he was going to get and how those medications would interact with the liver or heart.
As Dan was led into surgery, his care was placed in the capable hands of cardiac surgeon Duc Thinh Pham, MD, and his surgical team. Their approach would not only make for an efficient transplantation of Dan’s new heart, but also provide Dan’s liver team with an easier path for his liver transplant.
We had a rare opportunity with this procedure. By performing both transplantations in one day, we were able to provide our colleagues on the liver transplant surgical team much more abdominal exposure than they’re used to having.
After being sedated, Dan’s chest cavity was carefully opened up, and tubes were inserted to circulate oxygen and blood while his heart and lungs were bypassed. Once circulation was completely diverted, his diseased heart was removed and replaced with the donor organ. With a small burst of electricity, Dan’s transplanted heart began to beat in its new home.
One organ transplant takes a heavy toll on the body, but Dan was only halfway home. Swiftly, his heart transplant and liver transplant surgical teams switched places in the operating room, with leadership being ceded to senior transplant surgeons Daniela P. Ladner, MD, MPH, Juan Carlos Caicedo, MD, and Nitin N. Katariya, MD. Anesthesiologist Choy R. Lewis, MD, stayed put, as her experience extended to both of these complex procedures, which was beneficial to Dan’s team – a unique medley of the heart and liver transplant surgeons at Northwestern Medicine.
This was the first dual liver and heart transplantation that Northwestern Medicine had performed in over a decade. For it to go so smoothly is a credit to the preparedness and skill set of everyone on Dan’s team.
Together, Dr. Ladner, Dr. Caicedo, and Dr. Katariya made small incisions underneath Dan’s ribs, then clamped the arteries and veins supplying blood to his diseased liver. The liver was carefully removed and replaced with the donor liver, which was then reattached to the surrounding vessels and bile ducts. Dan’s path to full recovery would take months. But with his Northwestern Medicine care team’s collective depth and experience, his treatment plan would return him to a high quality of life.
We can’t do any of this without our nurses. They perform all the daily measures. They talk to the patient on a daily basis. They shepherd the patient into transplant. Their work is the lion’s share of the process. They’re the heart and soul of everything we do, no question.
What makes us better, makes you better.®
Living For His Family
Dan’s successful dual transplant ensured that he would be there for the people who mean the most to him: his family. In fact, while he was recuperating, one of his three daughters gave birth to a bright-eyed grandchild.
Dan is a good person, and his story is amazing. He remained positive throughout the process, and I look forward to seeing him continue to embrace life.
The magnitude of his procedure isn’t lost on Dan, who still corresponds with numerous members of his care team. Whether they knew it or not, while they were saving his life, they were also making a lifelong friend.
This isn’t just about physicians; it’s about our incredible nursing staff, mid-level providers, secretarial staff, medical assistants, social workers, residents, interns, fellows — I’d say over 200 people in our medical system helped him heal.