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He was in hospice at the time
Writing | Yanli Shen
Source | “Medical Community” Public Account
The 33-year-old foreign guy has returned to his normal life after 7 organ transplants.
This is also the world’s first successful multi-organ transplant. Seven organs were transplanted including liver, stomach, pancreas, duodenum, spleen, small intestine and right colon. The operation lasted 17 hours, and the patient recovered smoothly.
This “medical miracle” took place at the Cleveland Clinic in the United States.
In 2021, the clinic saw a patient with pseudomyxoma peritoneum, who was at an advanced stage of the disease, unable to eat solid food, receiving nutrition only intravenously, and even in hospice care.
Peritoneal pseudomyoma (PMP) is a rare cancer characterized by multiple myxoid growths in the peritoneum with massive mucinous ascites, usually arising from Tumors of the appendix.
When the tumor ruptures, it penetrates the cyst wall, allowing the mucous epithelium to grow on the peritoneum and secrete mucus to form a pseudomyxoma peritoneum.
Its jelly-like contents can also spread to other digestive organs, develop other multiple tumors, impair gastrointestinal function, and ultimately lead to malnutrition, which can be life-threatening in severe cases.
From the past clinical point of view, 80% of PMP patients are effectively treated with traditional therapy, that is, surgical resection of the lesion, combined with radiotherapy and chemotherapy. According to literature reports, the 10-year survival rate is 18%~ 40%.
But there are 20% of patients who do not respond to conventional treatments, and this patient belongs to that 20%. Often, this group of patients has few treatment options.
After his diagnosis in 2019, he embarked on a long journey of treatment, but has yet to find a way to stop the wanton expansion of tumor cells in his body.
Two years later, he was in a “dying condition” when he came to the Cleveland Clinic. The patient was seen by Dr. Anil Vaidya, co-director of the clinic’s bowel transplant program. “This patient is one of the most advanced cases of PMP I’ve seen,” Dr. Vaidya said.
But Dr. Vaidya suggested that he might try a multi-organ transplant. In July 2021, after a thorough and careful assessment, he was placed on the national transplant waiting list. In September 2021, he waited for a donor, and less than 24 hours later, the patient underwent the groundbreaking procedure.
The operation was performed by Dr. Anil Vaidya and a team of seven surgeons and lasted 17 hours.
The first three hours are preparations and all diseased abdominal organs are removed. Next, 7 donor organs were inserted into the abdominal cavity, all necessary vascular connections were made, and a left ileostomy was performed to dispose of bodily waste. After the transplant, the patient continued to be hospitalized for 51 days and was discharged without incident.
However, shortly after being discharged from the hospital, he returned.
Because he has graft-versus-host disease, a common condition after an intestinal or bone marrow transplant, the immune cells of the donated organ recognize the recipient’s tissue as foreign and attack the recipient .
Amy Lightner, a colorectal surgeon and director of the Cleveland Clinic Center for Regenerative Medicine and Surgery, used three doses of mesenchymal stromal cell (MSC)-derived exosomes, It was treated, which is also a new therapy in solid organ transplantation.
After this treatment, the patient’s recovery has been amazing. “His symptoms subsided within two hours of the first dose.”
Now nine months after the transplant, the 33-year-old patient can eat and digest solid food again, and has the energy to do things he enjoys, such as walking outdoors and cycling.
“There is currently no evidence of cancer recurrence,” Dr. Vaidya said.
Source: Medicine
Editor in charge: Wang Hang
Proofreading: Zang Hengjia