MORGANTOWN — Nark Kumaravelan of Fairmont has special reason to give thanks this holiday season. On Nov. 19, he received the first dual organ transplant in West Virginia at Ruby Memorial Hospital.
That day, the WVU Medicine Transplant Alliance provided Kumaravelan with a new heart and kidney.
“I’m so grateful to the transplant team at WVU Medicine for their amazing work, and I’m most grateful to the donor and the donor’s family,” Kumaravelan, 48, said in a release announcing the procedure. “I know my life is being extended through the generosity and kindness of that person; I’ll honor that gift each and every day through my own acts of kindness.”
The Dominion Post spoke with WVUM President and CEO Albert Wright and with Michael Shullo, WVUM associate vice president of transplant services, about the groundbreaking procedure.
The Alliance performed its first transplant just a year ago, Shullo said, so offering this dual transplant was a significant step forward. Dual organ transplants are offered at centers across the country; they’re more or less common depending on the region.
Kumaravelan had both chronic heart dieseae and kidney failure, they said.
“If we had not offered this for this individual, he would have had to go elsewhere for the opportunity,” Shullo said. “Or even worse, he would have had to have a heart transplant and go on the traditional kidney wait list, which is five years on average.” By offering both procedures, they were able to treat him at the time he needed it.
“This is one of our own, somebody in our primary service area,” Wright said. Seeing his need, the Alliance thought, “We think we can do this.”
They started Kumaravelan’s evaluation for needing a heart over summer and during that realized he also needed a kidney, Shullo said. They finalized his evaluations a few weeks ago, so Kumaravelan didn’t have a long wait afterward.
The two procedures took a combined 9.5 hours, but there was more to it, Shullo explained.
“It’s quite detailed,” he said. When a donor becomes available – all donor information is confidential – the organs have to be allocated to the facilities across the country that are waiting for them. WVUM sent a team to the site to coordinate with other teams.
The heart is one of the first organs harvested and the team brought that back to Ruby Memorial Hospital, where the heart team began work.
The kidney is one of the last organs harvested. So the kidney team set up their operating room while the kidney was in transit and the heart team was working.
After the heart transplant was completed, Kumaravelan recovered briefly in an ICU before being moved to the kidney OR for that transplant.
“It does take some juggling to get all the teams where they need to be,” Shullo said.
Kumaravelan continues recuperating in a cardiac ICU, they said.
“This is big news,” Wright said, “but it’s really just the start of a lifetime journey of trying to keep this young man healthy and keep those organs functioning.”
He will need anti-rejection medications for the rest of his life, they said. They are first administered intravenously during the procedure, Shullo said, and transitioned to oral forms.
Wright wanted to be sure to recognize the person who took the time to become a donor and give life to someone else, and to the donor’s family.
Wright and Shullo both offered some observations on what’s ahead now that this milestone has been reached.
“Becoming a solid organ transplant center was a major investment for us and a major move forward as a comprehensive academic medical center and comprehensive academic health system,” Wright said.
They are doing heart transplants on a regular basis and have a list of kidney transplant patients.
“I think the program will continue to grow, though dual transplants are rare,” Wright said. “But if it comes up again, this only builds our confidence in doing it.”
They want to look at doing transplants from living, related donors. And perhaps, in a couple years, they may look at transplanting other organs, such as livers and lungs.
“Our job and our goal as we continue to grow is to be as comprehensive as we can and take care of all West Virginians in an integrated fashion,” and also serve people form Pennsylvania, Ohio and Maryland.
Along the same lines, Shullo – who led transplant programs in Pittsburgh and elsewhere before coming to WVUM – said their goal was to develop a world class transplant program.
“I think we’ve done that,” he said, “But to really do it well, we need to continue to increase the number of patients that we help from the state of West Virginia, increase our numbers of kidney transplants and heart transplants. Once you do that, it allows you to do more innovative things.
They want to reach the point, he said, that “this academic medical center can offer everything that any other transplant program that a large, renowned academic medical center can offer, and folks don’t have to leave” West Virginia to get care.
One last thought they shared was on teamwork. The team is called Transplant Alliance for a reason.
“This is truly a team sport,” Wright said. The procedures involved caridac, thoracic, abdominal and tranaplant surgeons, cardiologists, phrenologists, infectious disease specialist, a clinical pharmacist and more. “Our teams excelled in the operations. … I’m very proud of our team.”
Similarly, Shullo said, “Transplant is the ultimate team sport.” The regulatory and clinical needs require a long lsit of people who take care of patients on the front lines and behind the scenes. “I would like to commend the team that we have here, that we are able to do this so quickly.”
The release named some of those involved: Heart transplant surgeons Vinay Badhwar and Jeremiah Hayanga performed the heart transplant. Transplant cardiologists George Sokos, Marco Caccamo and Christopher Bianco provided pre- and post-operative cardiology care. Lynsey Biondi Roberto Lopez-Soltis performed the kidney transplant with transplant nephrologists Dinesh Kannabhiran and Vishy Chaudhary providing pre- and post-operative kidney care.
Tweet David Beard@dbeardtdp Email dbeard@dominionpost.com
