Organ transplant surgeons perform UCLA's first double lung-liver transplant
Jennifer Golden, a 19-year-old college student from Las Vegas, got her Christmas gift early this year — a pair of life-saving lungs and a liver at Ronald Reagan UCLA Medical Center on Dec. 4.
The rare combination surgery, thanks to the gift of one donor, also marked a milestone for the hospital’s organ transplant program: It was the first operation of its kind ever performed at UCLA.
Jennifer Golden, 19, has cystic fibrosis, which caused her lungs to develop infections that were becoming increasingly difficult to treat. Thanks to a donor and her UCLA surgeons, she now has a new pair of lungs and a liver, the result of a rare combination surgery, the first to be performed at the Reagan UCLA Medical Center.
The young woman has a genetic condition called cystic fibrosis, which causes thick, sticky mucus in her lungs that traps infection-causing bacteria. As a result, Jennifer experienced shortness of breath, excess mucus, coughing, an inability to gain weight and diabetes.
Her disease was managed by a routine of "tune-ups" to clear the mucus in her lungs with antibiotics, intravenous medications, physical therapy and other procedures. However, over the years, her lungs developed infections that became increasingly difficult to treat. To make matters more complicated, Jennifer’s liver function was also affected by the disease. By her senior year, she was so sick she could no longer attend high school.
At age 17, with her lungs and liver simultaneously deteriorating, she was told her only chance at life was organ donation.
"I felt every emotion — scared, nervous, but also happy that this could save my life," Jennifer recalled.
A double lung-liver transplant surgery is rare. According to the most current data available from the United Network for Organ Sharing which manages the country’s organ donation system, only 44 lung-liver transplants have been performed in the United States. It is also unusual for a cystic fibrosis patient to need both lungs and a liver. More commonly, because of the way the disease progresses, the patient needs only one organ or the other.
"Because of her small size and the necessity for both the lungs and liver to be usable, she knew — as did we — that her wait might be long," said Dr. Sue McDiarmid, professor of pediatrics and surgery, director of the pediatric liver transplant program and Jennifer’s doctor for 10 years.
Meantime, Jennifer’s entire lung and liver transplant team — including surgeons, physicians and anesthesiologists — spent a lot of time planning for her complex surgery. For example, the surgeons decided that the best approach would be for the lung transplant to be performed first.
"We also consulted with reconstructive surgeons to map out where we would make our incisions so that Jennifer’s abdominal muscles, bone and skin would not be impacted," added Dr. Doug Farmer, professor of surgery and surgical director of the pediatric liver transplant program. "Our goal was to perform the surgery efficiently and with minimal blood loss."
Two years later, on Saturday, Dec. 3, Jennifer got the call that a donor had been found. She and her mom quickly flew to UCLA while her dad followed behind in the family car.
Jennifer was wheeled into surgery around 4:45 a.m. on Dec. 4. The team’s intense planning paid off, and the 13-hour operation went smoothly.
When Jennifer came out of her surgery, her ability to breath was immediately improved. With the diseased lungs removed, her illness is now gone although her cystic fibrosis is not technically cured since it is part of her genes.
"We are quite optimistic that Jennifer will do well," said Dr. Abbas Ardehali, professor of cardiothoracic surgery and surgical director of the heart and lung transplant program at UCLA. "This is our mission here at UCLA to expand the horizon of transplant patients we can serve."
The former high school tennis team captain can now look to the future, and her plans include being with her fiancé, continuing her college studies and hitting the tennis courts again.
She also has a vital message to deliver.
"I hope that if a family out there is ever suffering with the death of loved one, they will consider the priceless gift of organ donation," Jennifer said. "Someone did that for me, and it saved my life. My family and I cannot thank them enough."
"Without organ donors and their families, stories like Jennifer's would have only tragic endings. Jennifer now breathes with ease — she is pink — her new liver is working very well, and all this because of this one donor whose life lives on in another," said McDiarmid.