Northwestern Medicine’s first successful liver-lung transplant

Patricio Colera considers August 25, 2022 as his new birthday. That same day, the Vernon Hills resident received a new lease on life with a liver and lung transplant thanks to the expertise of physicians at Northwestern Medicine.

Cholera’s combined lung-liver transplant was the first successfully performed by the health system. An operation that was planned and executed by about two dozen medical professionals, it took a total of six to seven hours to complete and a series of dry runs and exercises to ensure that any problematic situations were planned for.

“I feel like someone could have easily made a ‘Grey’s Anatomy’ episode with all the fun and action that’s going on,” said Dr. Ankit Bharat, chief of thoracic surgery at Northwestern Medicine. He removed Cholera’s right lung and replaced it with a new one. Director of Northwestern Comprehensive Transplant Center. Satish Nadig, an abdominal transplant surgeon and chief of organ transplantation in the Department of Surgery at Northwestern University Feinberg School of Medicine, performs liver transplants.

“The most complicated abdominal organ transplant is a liver transplant,” Nadig said. “A very complicated operation, combined with lung transplantation, has not been done very successfully in the country.

“But Nadig asked the question for this particular operation: ‘Can we sew the lung and do the lung? Yes. Can we sew the liver and do the liver? Yes. We do it all the time, for both of our largest programs in the country. There’s one in between. Did we do it together? No. But the secret sauce was can we do it with a level of communication? I knew the answer was yes.’ We knew he was a high-risk candidate, but we also knew that if we matched him with a suitable organ recipient that we could give him a good outcome.”

Patricio Colera, a retired nurse who worked at Northwestern Memorial Hospital, the recipient of the health system's first successful combined lung-liver transplant, speaks at a press conference attended by his surgeon, Dr. Ankit Bharat, on Nov. 23, 2022.

So after he was turned down for a transplant by three different health systems for reasons such as age and a previous failed liver-lung transplant, Northwestern took on Cholera’s case.

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The 63-year-old retired nurse had pulmonary fibrosis, a lung disease that occurs when lung tissue thickens. As the condition improves, one has more shortness of breath.

By 2017, Cholera was on medication to treat her illness conservatively, but by 2019, she traveled everywhere with an oxygen tank and had to go on disability from her 32-year nursing career, two years of which she worked at Northwestern Hospital. His liver problems became real when it was discovered that the medication he was taking had hurt him. This, combined with a bout of cholera in his younger days, fibrosed his liver.

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“I was disappointed,” Colera said. “And finally, the medical director at Northwestern gave me so much hope, ‘We’re going to transplant you, not just your lungs, but your liver.’ It was the best news of my life.”

Cholera was placed on the transplant waiting list on August 15. He had two offers in less than a week, but one donor had perfect lungs but a failing liver, while the other offer was the opposite. But after 10 days on the list, Cholera called with another potential donor. It had a perfect liver and a good right lung.

“I told my wife, ‘I’ll take this one lung and perfect liver, it’s God’s blessing,'” he said. “The next time I woke up, I was in the ICU. The first words I asked the medical assistant, I wrote down on a piece of paper. ‘Am I alive or dreaming?’ And he said, ‘Yes, Patricio, you are alive.’ That was a tear-jerker. I cried.'”

Cholera received her life-changing surgery three months after Thanksgiving, and she’s grateful. She said she became more spiritually inclined following his method. His faith grew stronger.

“I believe my life after surgery is a miracle,” said Leyte, a resident of an island in the Philippines’ Visayas archipelago. He is encouraging the public to become donors and those with diseases that require a transplant to go for it, because “your life will really change. There’s nothing to be afraid of.”

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Kolera is willing to share his life story (how he got into nursing after his older sister: a nurse suggested it; he came to the US in 1988 and his wife is also a nurse) to anyone willing to listen.

“If you saw me three, four months ago, my life was miserable. I was dragging oxygen everywhere I went,” he said. “If there’s anything I can do to make you more comfortable with the idea of ​​a transplant, let me know. … You don’t have to worry.”

Kolera is now looking to pass on the nursing skills she picked up as a PICC (peripherally inserted central catheter) nurse to the next generation of nursing home caregiving workers.

“What better way to do that than with a former Northwestern nurse as our first success?” Dr. Nadig. “There’s a buzz around Northwestern, a forward thinking.”

“We innovate when needed,” says India. “Surgery textbooks were written more than 30 years ago. … People don’t even want to keep their iPhone for more than a year. Why are you following textbooks written 30 years ago? There are many opportunities to bring in new technologies… being developed to take things to the next level. What we really believe is how can we move the line a little bit to the right, ‘How can we do better than what’s out there?’

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