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Archive for July, 2013

Weeping Water Man Ready to Get on with His Life

State’s first artificial heart patient goes home

 

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Greg Rathe, Nebraska’s first artificial heart recipient, gets final instructions from heart failure specialist Eugenia Raichlin, MD, prior to leaving the hospital following a heart-kidney transplant.

 

In the hours before Greg Rathe, Nebraska’s first artificial heart patient, left The Nebraska Medical Center, he donned a blue ball cap with a bright red and yellow Superman logo. At 111 pounds, down from his usual 155, he might not have looked the part, but considering what the Weeping Water, Neb., man had been through over the past few months, the hat couldn’t have been more fitting.

“I honestly didn’t think I was gonna make it through this time,” recalls the 42-year-old Rathe, moments after gulping down his second chocolate malt of the day. “I got 16 years out of my first heart transplant, which is pretty good. But without the artificial heart, I probably wouldn’t be here today.”

A few days after receiving the artificial heart on March 14, Rathe looked every bit the part of man who was extremely sick. “I was tired, I know,” he remembers. “I didn’t think I looked that bad. But everybody says I did.” Now, just weeks after receiving a new heart and kidney as well, Rathe looked markedly different – alert, talkative and ready to go home to friends and his favorite fishing hole.

“It’s a big victory,” says Eugenia Raichlin, MD, Rathe’s heart failure specialist. “He’s a very strong person, so I’m not surprised. I’m pleased.”

John Um, MD and Michael Moulton, MD, performed the heart transplant and Michael Morris, MD, completed the kidney procedure in an 11-hour operation May 17.

Rathe says he immediately felt better when he woke up. “You can just breathe. You can feel your body again.”

The former truck driver plans to do some walking and swimming to get his strength back and lift some weights to start rebuilding the muscle in his arms, which are now “just sticks,” he says.
And in the not-too-distant-future, Rathe will get a chance to do what he really loves. He’ll go camping and fishing.

Distinguished Scientist ceremony features surprise ending

by John Keenan, UNMC public relations

 

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Surinder Batra, Ph.D., received the award as UNMC’s seventh Scientist Laureate, the highest honor UNMC bestows to researchers 
UNMC Chancellor Harold M. Maurer, M.D., was at Tuesday’s Distinguished Scientist ceremony to hand out awards.
He didn’t expect to receive one.

Dr. Maurer was presented with an Honorary Scientist Laureate Award at the close of the ceremony by Jennifer Larsen, M.D., vice chancellor for research. The award, Dr. Larsen said, was to commemorate the growth in research activities at UNMC under Dr. Maurer’s leadership.
“Dr. Maurer has made it very clear, from when he became chancellor to now, how important research and the growth of research is to UNMC’s national stature,” Dr. Larsen said. “It is in part because of his leadership and continued emphasis on research that we are where we are today.”
See a slideshow of the event.

Surinder Batra, Ph.D., professor and chairman, department of biochemistry and molecular biology, was named UNMC’s seventh Scientist Laureate, the highest honor UNMC bestows to researchers.

Other researchers honored at Tuesday’s ceremony included:
Distinguished Scientists

  • Patricia Hageman, Ph.D., School of Allied Health Professions
  • Gleb Haynatzki, Ph.D., College of Public Health
  • Terry Huang, Ph.D , College of Public Health
  • Xu Luo, Ph.D., Eppley Institute
  • Amarnath Natarajan, Ph.D., Eppley Institute
  • Bunny Pozehl, Ph.D., College of Nursing
  • Risto Rautiainen, Ph.D., College of Public Health
  • Mark Rupp, M.D., College of Medicine
  • Mohammad Siahpush, Ph.D., College of Public Health
  • Dong Wang, Ph.D., College of Pharmacy

New Investigators

  • Mark Carlson, M.D., College of Medicine
  • Julia Houfek, Ph.D., College of Nursing
  • Ashish Joshi, M.D., Ph.D., College of Public Health
  • Benita McVicker, Ph.D., College of Medicine
  • Jim Stimpson, Ph.D., College of Public Health

Surgeons Repair Complex Aneurysm Without Major Incision

“Fenestrated Graft” Procedure is the first ever done in Nebraska
Jamie Reynolds is a living, breathing reminder of why it’s important to stay on top of your own health. The 78-year-old grandmother from Omaha says she always goes for an annual checkup. Her most recent one showed something she neither felt, nor expected – an aneurysm in her aorta.

“I got a CAT scan and an MRI and that’s where they picked it up,” Reynolds says. “They told me I had an enlarged aorta. I said, ‘What’s that?’ They showed me where it was positioned.”

Reynolds’ primary care physician referred her to vascular surgeons Matt Longo, MD and Jason MacTaggart, MD at The Nebraska Medical Center. They explained to her that the aneurysm, or bulge in the aorta, the body’s main artery might best be repaired with a new type of minimally invasive surgery – placing a fenestrated graft inside the aorta.

 

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Dr. Jason MacTaggart (left) and Dr. Matt Longo (right) begin the fenestrated graft surgery to repair Jamie Reynolds’ aorta. Reynolds didn’t have to think long about whether or not to go through with it.

“I said, ‘Let’s get busy!’”

“A graft is a fabric tube we use to replace a blood vessel wall,” explained Dr. MacTaggart.

For several years, medical center surgeons have been repairing aortic aneurysms endovascularly by guiding a fabric and metal mesh graft, compressed to the width of a pencil, through an artery in the leg. Surgeons position it inside the bulging aorta without doing surgery. Reynolds’ aneurysm was located in the spot where the arteries supplying blood to the kidneys branch off from the aorta. That meant surgeons could not place a conventional graft inside the aorta without cutting off circulation to the kidneys. The fenestrated graft provides “branches” from the main graft that allow blood to continue flowing to the kidneys. Doing such a repair with only two small incisions in the leg is a major advancement.

“Historically, when we’ve seen aneurysms in that area, we’ve been forced to do open aneurysm repair,” Dr. Longo says. “Which involves a big incision on the belly and sometimes the leg. Open surgeries have higher complication rates, longer hospital stays, and usually mean a much, much longer recovery for the patient.”

That point was not lost on Reynolds, who is proud to be the first patient in Nebraska to have this type of procedure done.

“I told my doctor, ‘Oh, I made history?’ And we laugh about it,” she said. “The technology is better now. They went through my groin which was much better than going through my tummy.”

 

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Dr. Matt Longo looks at an X-ray image of the fenestrated graft inside Reynolds’ aorta. Drs. MagTaggart and Longo describe the operation as an exercise in teamwork.

“While Jason is working on one side to bring the graft up, I can work simultaneously on the arteries that supply the gut,” Dr. Longo explains. “That’s the trickiest part; making sure we have everything aligned.”

There are several pieces to the fenestrated graft: the main graft that goes inside the bulging aorta, and the side branches that will line the kidney arteries and connect to the main graft. Each graft is custom-made for the patient’s specific anatomy.

“Essentially, we put them together on the inside,” Dr. MacTaggart says. “It’s similar to an erector set we played with as kids.”

Using X-rays, the surgeons carefully guide the grafts into place. When all parts of the grafts are connected, they use dye in the blood stream to make sure the blood is flowing properly and that the aneurysm is sealed off.

The Nebraska Medical Center is the only hospital in the state providing this surgery.

“There are only a handful of places where you can have this done,” Dr. Longo says.

“The advantage here is that you have five surgeons who are very involved with aortic and vascular surgery,” says Dr. MacTaggart. “Ten eyes are better than two.”

Both surgeons say Reynolds’ surgery went very well. She recovered quickly and was back home a few days after her operation. A recent checkup showed her newly reinforced blood vessels are doing very well. And she has important advice for anyone.

“Don’t put off getting a physical. I go every year. And this one saved my life.”

 

 

UNMC physician changed transplantation

by Vicky Cerino & Liz Kumru
Dr. Anne Kessinger proved there was another way of collecting stem cells and revolutionized treatment.
They said it couldn’t be done. But Anne Kessinger, M.D., a Scribner, Neb., resident, did it.

In 1981, bone marrow transplants were just beginning to be used to treat some blood cancers such as lymphoma and leukemia. In some cases it helped provide a cure. But, for patients whose cancer had invaded the bone marrow, there were no options.

Dr. Kessinger, professor in the UNMC Division of Oncology/Hematology and at The Nebraska Medical Center, wanted to know if there was another way of collecting stem cells derived from the blood of patients.

At the time, the only way to collect stem cells from the bone marrow was to put the patient under general anesthesia then insert a long needle into the hipbone 100 or more times until enough stem cells were collected to perform a transplant.

Dr. Kessinger felt there had to be an easier and less painful way.

She knew peripheral blood stem cell transplants were successfully used in animal models as early as the 1930s and common sense told her that they also could work in humans.

With the help of the Omaha Red Cross, Dr. Kessinger and her colleagues figured out a way to collect the cells through a special process called apheresis — through veins in the arm much like donating blood.

The process was effective and enabled the use of peripheral blood stem cell transplantation in humans. The therapy provided an alternative and is now standard practice around the world.

The first peripheral blood stem cell transplant at the medical center was performed on June 6, 1984.

When Dr. Kessinger published the results of the clinical trial she conducted with 10 patients, her article was questioned by the medical community. Her colleagues around the world thought she had either fabricated results or misinterpreted them. At first, the medical journals would not accept her reports.

She eventually proved to the world that her data were correct, conventional dogma was wrong and peripheral stem cell transplantation could work.

To read more about UNMC’s leadership in bone marrow/stem cell transplantation, go to http://www.unmc.edu/aboutunmc.htm. Stories are listed under “UNMC News.”

Through world-class research and patient care, UNMC generates breakthroughs that make life better for people throughout Nebraska and beyond. Its education programs train more health professionals than any other institution in the state. Learn more at unmc.edu.

Transplant voices

by Vicky Cerino, UNMC public relations

 

To mark its 30-year anniversary, UNMC Today talked with doctors, patients and staff about the transplant program.

We asked:

“What have you learned from your patients about medicine and the field of transplantation?”

 

bierman
   
Philip Bierman, M.D. 

 

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Theresa Franco, M.S.N. 

 

Philip Bierman, M.D. – professor, Internal Medicine, answers:

“It’s hard for me to express my admiration for the way our patients put their faith and trust in us. They are going through a bad period in their lives, but they are invariably kind and gracious. They are understanding even when they get bad news or when we answer their questions with, “I don’t know.” Our patients rarely complain, no matter how bad they feel or how serious their condition is. I know this is what makes me and my colleagues enjoy doing what we do.”
What has it meant to you to be part of the transplant program?

Theresa Franco, executive director Cancer Care Service Line, The Nebraska Medical Center, answers:

“Being a part of the transplant program has been the most rewarding experience of my career at the medical center. It has been an honor to be a part of a team that has made a commitment to patients to deliver state-of-the-art compassionate transplant care. I never imagined I would have the privilege of working with so many talented individuals who have made an impact on so many professional and personal lives. What an incredible journey.”

 

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Bill Penry 

“What difference has having a transplant made in your life?”

Bill Penry of Omaha answers:
“After being told I had less than a month to live, and then successfully undergoing two separate bone marrow transplants, it is easy to say what it means to me. It means life – and living it well. And 20 years after the fact, the UNMC program is extremely successful, and I am alive and very well. Is there anything in this world more important than that? Not to my wife of 45 years, nor to our two children, nor to my employees, nor even my cats. And certainly not to me.

“All of us who have received this second chance, this extension of life as we know it, recognize what the UNMC transplant programs are, as well as the personnel that make them what they are.
“And we all are thankful beyond words.”

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