January 28, 2000

First triple organ transplant at Vanderbilt performed

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Ronald and Teresa Hedgecoth visit with 18-year-old Darrell Hedgecoth, who this week underwent Vanderbilt’s first triple organ transplant. (photo by Dana Johnson)

First triple organ transplant at Vanderbilt performed

Vanderbilt University Medical Center surgeons this week performed the institution's first-ever triple organ transplant.

The rare procedure — only about a dozen triple organ transplants have been reported worldwide — involved removing the patient's heart, lungs and liver and replacing them with organs recovered from a donor who had died in a motor vehicle accident.

The patient, 18-year-old Darrell Hedgecoth, of Ashland City, is currently recovering in VUMC's Surgical Intensive Care Unit. Hedgecoth suffered from cystic fibrosis and has been a patient of the Vanderbilt Cystic Fibrosis Center since he was diagnosed 10 years ago.

The 11-hour operation, which began Sunday morning, was a team effort involving nearly 100 people, including transplant surgeons, anesthesiologists, nurses, technicians and residents.

"A lot of people worked very hard and very efficiently to accomplish this," said Dr. C. Wright Pinson, professor of Surgery and surgical director of the Vanderbilt Transplant Center. "It involved the coordination of multiple teams from several transplant programs. And a lot of the credit goes to the CF team who took care of Darrell here at Vanderbilt for so long."

According to Pinson, the triple organ transplantation procedure was broken down into several major steps: removing the organs from the donor; resecting Hedgecoth's heart and lungs; implanting his new heart and lungs; removing his liver; and implanting his new liver.

Also involved in the surgery were Dr. Davis C. Drinkwater Jr., William S. Stoney Jr. Chair in Cardiac and Thoracic Surgery and surgical director of the heart transplant program; Dr. J. Kelly Wright Jr., associate professor of Surgery; Dr. William C. Chapman, associate professor of Surgery; Dr. Piotr K. Janicki, associate professor of Anesthesiology; and Dr. E. Wesley Ely, medical co-director of the lung transplant program.

For the rest of his life Hedgechoth, a senior at Cheatham County High School, will have to take powerful anti-rejection medications to keep his body's immune system from attacking his new organs.

The five-year survival rate for patients following lung or heart-lung transplantation is approximately 50 percent. At this point, not enough triple organ transplants have been performed to determine long-term survival rates.

Approximately 30,000 people in the United States have cystic fibrosis. It's marked by an accumulation of mucus, repeated infections and progressive lung disease and many patients eventually require a lung transplant. In Hedgecoth's case, the disease also affected his heart and liver, and the decision was made to transplant all three organs if they became available.

Hedgecoth has been on the transplant waiting list for six months and at the time of his procedure only weighed 100 pounds.

"We knew he didn't have much time left," said Dr. Dennis C. Stokes, associate professor of Pediatrics and director of the Vanderbilt Cystic Fibrosis Center.

Stokes, who has cared for Hedgecoth for 10 years, says the teen is now breathing on his own and is doing as well as anyone who has just had three organs replaced can be expected to be doing.

"He looks good and considering the kind of surgery he's just gone through, he's doing great," Stokes said.

"We're thrilled because Darrell is really a special kid."

Darrell's father, Ronald Hedgecoth, said his son is a fighter who won't give up, and when it became clear a year ago that Darrell would need a transplant, there was no doubt where it would take place.

"Darrell wanted to do it here where he's been coming for 10 years. The people up on 6 South are like his family and he wanted to be around his family," Ronald Hedgecoth said.