July 7, 2017

Veteran receives rare dual transplant of heart and liver at Vanderbilt

A veteran of the U.S. Coast Guard recently received a new heart and liver at Vanderbilt University Medical Center (VUMC), one of only a handful of hospitals that have performed the dual transplant surgery this year.

A veteran of the U.S. Coast Guard recently received a new heart and liver at Vanderbilt University Medical Center (VUMC), one of only a handful of hospitals that have performed the dual transplant surgery this year.

Michael Wilcher embraces his wife, Celeste, while recuperating from his recent transplant procedures. (photo by Anne Rayner)

Michael Wilcher underwent the surgery on June 28.

“I am forever indebted,” he said. “The VA and Vanderbilt came in and stepped up to the plate just when we needed them the most.”

Wilcher, 58, of Wilmington, Del., ended up at VUMC through the Veterans Health Administration because medical centers in his network closer to his home did not have the expertise to do the procedure. Only 18 heart and liver transplants occurred at U.S. hospitals in all of 2016, according to data from the Organ Procurement and Transplantation Network (OPTN).

“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 had been 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 and eating breakfast and making a special request for oatmeal.

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 the liver surgeons for the dual transplant.

“This transplant was made possible by the remarkable partnership between the Veterans Affairs hospital system and Vanderbilt,” Karp said. “We are so proud to be able to provide the very best care to our veterans. In addition, the vision of leadership of Dr. Sophoclis Alexopoulous, chief of Liver Transplantation at Vanderbilt, Dr. Shah and Dr. Joseph Awad, chief of transplantation at the VA (Tennessee Valley Healthcare System), allowed us to develop this program and will hopefully enable us to expand it to the growing number of patients who can benefit.”

While this was not VUMC’s first dual transplant, it was the first one 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 had already been diagnosed with idiopathic cardiac myopathy when he learned he also had cirrhosis.

“That was like a damning,” said Wilcher, who had been cured of hepatitis and stopped consuming alcohol 10 years ago, but still had lasting liver damage. “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 14-year-old son kept him fighting for his life after other medical centers told him they couldn’t accept him as a patient for the dual transplant.

“My wife and I are so grateful and thankful for Vanderbilt being willing to take on a risky operation,” Wilcher said.

VUMC is home to the second busiest heart transplant program in the country and ranked number one in the Southeast region for volume for its combined adult and pediatric procedures, according to data released by OPTN.

VUMC is also among the top hospitals in the United States performing liver transplants, according to a recent report published in the American Journal of Transplantation. Vanderbilt performed 149 adult liver transplants between July 2015 and June 2016. The volume ranks VUMC at No. 4 in the nation, according to the study, which is based on data released by the Scientific Registry of Transplant Recipients.