Unique Transplant Surgery Beats Cancer

Pancreatic Cancer Slideshow

Surgeons Take Out Organs, Remove Tumors, and Then Put Organs Back

By Denise Mann
WebMD Health News

Reviewed By Louise Chang, MD

March 24, 2008 — Florida transplant surgeons announced the first successful multi-organ transplant in which they temporarily took out all of the organs in the abdomen of a 63-year-old South Florida woman with a rare type of cancer so they could remove the tumor and its blood supply.

The surgical team discussed the 15-hour surgery at a news conference Monday at the University of Miami/Jackson Medical Center in Florida.

"This is very brand new and unique approach," says Tomoaki Kato, MD, the transplant surgeon who led the operation. "We have done a multi-organ transplant before, but not in the same person. We have removed multiple organs and then put them back in another person. It is very risky and definitely one of the most challenging surgeries of my career."

But so far, so good.

The surgery took place three weeks ago. The patient, Brooke Zepp, is doing "great," Kato tells WebMD. "She is considered cured at this point, but only time will prove its long-term efficacy."

When Zepp watched a graphic video of the grueling surgery during the news conference, she held back tears and said she couldn't believe it was her.

Vexing Tumor Location

The transplant surgery was so tricky because the tumor, called a leiomyosarcoma, was located deep in the patient's abdomen and wrapped around the aorta and the base of the celiac and superior-mesenteric arteries. These arteries supply blood to the stomach, pancreas, liver, spleen, small intestine, and much of the large intestine.

"If we tried to remove this tumor in the usual way, it would cause damage to the organs supplied by all these arteries," Kato said at the news conference. "This is considered inoperable using a usual surgical approach."

There was literally no room to remove the tumor without damaging the organs. Given six months to live and told that the tumor was inoperable by multiple surgeons, Zepp underwent a combination of chemotherapy and radiation to kill the cancer at other medical centers, but the treatments did not work.

Organs Put on Ice

"We took a very unusual approach and took everything out of the body temporarily," Kato explains. "All the intra-abdominal organs and part of the aorta were temporarily removed, chilled, and preserved outside the patient's body."

Then, the tumor and the vessels were removed from the organs and placed in an ice-cold basin.  "The blood vessels were then replaced with artificial ones and all the organs were reimplanted in their normal position."

This proved the most difficult part of the surgery, he tells WebMD. "After removing the organs, we have to make sure that we will be able to put them back in a good condition." No anti-rejection drugs are needed as the patient is getting back the same organs that were removed.

This may be the tip of the iceberg, Kato says. "The new surgery may one day benefit people with other tumors that are located in the same area."

SOURCES: News release, University of Miami School of Medicine. Tomoaki Kato, MD, transplant surgeon, University of Miami/Jackson Medical Center. Brooke Zepp, patient.

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