"Combined heart/liver transplants are so rare that the best technique for a combined implantation has not yet been elucidated," says Dr. Kevin Lachapelle, a Cardiac Surgeon at the MUHC, who performed the combined procedure with Dr. Peter Metrakos (Liver Surgeon). "Historically these procedures are done separately, but because both organs were procured from Quebec City at the same time by MUHC Drs. Ergina and Paraskevas and because sequential transplants can have a profound negative effect on the heart, we decided a simultaneous implantation offered the best hope of success."
The patient, Patrice Dionne, who was referred to the Institut de cardiologie de Quebec for medical evaluation for a possible heart transplant, was transferred to the MUHC after liver complications necessitated a complex multi-organ transplant. "The patient had waited three years for a heart transplant, during which time his liver began to deteriorate," says Dr. Bernard Cantin, Director of Heart Transplantation at the Institut de cardiologie de Quebec. "At this point we knew the MUHC was the only hospital where we could transfer our patient for this lifesaving surgery." The speed and ease at which this patient transfer occurred demonstrates the level of collaboration and teamwork that exists between hospitals within Quebec.
"The patient made a rapid recovery after surgery, and was discharged after only 10 da ys," says Dr. Nadia Gianetti, Medical Director the Heart Failure and Heart Transplant Program at the MUHC. "The seamless collaboration between the cardiac and liver transplant teams at the MUHC is one of many reasons why the planning, surgery, and follow-up care of Mr. Dionne was so straightforward and uncomplicated." The patient has now fully recovered and is again living a full and rich life. "I am extremely impressed with the doctors at the MUHC; from the onset I had unquestioned confidence in their ability to perform this complex surgery," says Patrice Dionne. "I'm so thankful that I will now be able to enjoy this fathers day with my three sons."
"As a comprehensive Multi-Organ Transplant Program, we are accustomed to collaborating with other institutions across Quebec and other provinces for this form of highly specialized patient care," says Dr. Renzo Cecere, Surgical Director of Heart Failure and Heart Transplantation at the MUHC. "We are particularly pleased to have specialists from every discipline with a strong interest in transplantation, allowing us to successfully offer combined organ transplants within one institution."
The world's first heart transplant was conducted less than forty years ago; complex combined transplants have only been conducted since the 1980's. Multi-organ transplants, such as the combined heart-liver transplant conducted at the MUHC require a multi-specialized team, consisting of cardiologists, hepatologists, intensive care specialists, anesthesiologists, nurses, physiotherapists and Transplant Quebec coordinators. Combined heart-liver transplants are rare--only a few successful procedures have been performed in Canada, and this is the first in Quebec.