Vanderbilt University Medical Center has performed its first combined liver transplant and Whipple procedure, an unusual combination procedure that rendered an East Tennessee man cancer-free.
Reginald Porter of Oak Ridge, Tennessee, received the procedure in September after being diagnosed at an area hospital in February with cholangiocarcinoma, a rare cancer that develops in the bile ducts.
“They let me know it was aggressive,” he said. “It’s bad.”
Porter came to Vanderbilt-Ingram Cancer Center, where after being evaluated by a multidisciplinary team, he was deemed an appropriate candidate for liver transplantation to cure his cancer and was started on an aggressive regimen of radiation and chemotherapy. After successfully completing appropriate treatment, he was placed on the liver transplant waiting list under very close monitoring. At the time of the liver transplant, an intraoperative biopsy revealed that to fully remove the cancer, Porter needed a Whipple operation, a major abdominal procedure that removes part of the pancreas, duodenum, gallbladder and bile duct.
Martin Montenovo, MD, MMHC, associate professor of Surgery and chief of the Division of Hepatobiliary Surgery and Liver Transplantation, performed the liver transplant and Sekhar Padmanabhan, MD, assistant professor of Surgery, performed the Whipple procedure.
“After liver transplant, the Whipple procedure is the biggest abdominal surgery that you can do on a patient,” Montenovo said. “He had basically two of the biggest abdominal surgeries that a human being can have.”
Montenovo noted that there are few centers in the country capable of performing a combined liver transplant and Whipple procedure. The procedure involves multiple specialties, including transplant teams and surgical oncology teams.
“This is a patient who went through medical oncology, radiation oncology, hepatology, transplant surgery, surgical oncology, GI endoscopy and interventional radiology,” Montenovo said. “There are so many people that they were involved in the care of Mr. Porter, and he did remarkably well.”
Porter will continue to be seen by Vanderbilt for medical oncology and hepatology. He gives the credit to God and to his Vanderbilt care team.
“It was wonderful,” he said. “I’ve never been treated so good in my life. And they let it be known that they were there to help me.”
Padmanabhan said, “Mr. Porter’s case is a testament to the interdisciplinary collaboration that happens all the time at a place like VUMC. We are so pleased he did so well.”
