Europe's First Heart-Kidney-Pancreas

John A. Macoviak MD is a retired heart transplant surgeon trained by Norman E. Shumway MD PhD and John C. Baldwin MD at Stanford, and L. Henry Edmunds MD at the Hospital of the University of Pennsylvania, practiced and taught medical students at Universities in California, Washington DC, and Boston from 1983 to 2002 and at Mayo Clinic in 2008-2009.

John A. Macoviak, MD, MBA, is a reputable medical professional focused on becoming an author and blogger. Known for performing the first heart transplant in Washington, DC. and the world's first Heart Transplant combined with Dr. Hans Sollinger's combined Pancreas Transplant John (J.A.) Macoviak, MD, MBA, has stayed abreast of combined medical transplants, including the first combined heart, kidney, and pancreas transplantation in Europe.

Multiorgan transplantation procedures involving the kidney, heart, and pancreas are not seen very often. This is because it’s rare that diabetic patients present with end-stage renal and cardiac failure at the same time. However, it does happen, as was the case with a 42-year-old male in Europe in 1990.

The man who received the first heart-kidney-pancreas transplant had been dealing with type 1 diabetes since the age of 13. He had been on insulin therapy since first being diagnosed. The disease took a toll on the man’s body, and he began dealing with diabetic nephropathy in 1984. By 1988, he began ambulatory peritoneal dialysis to his advanced renal insufficiency (RI). He had experienced congestive heart failure (CHF) a couple years prior.

On top of his worsening CHF, which ultimately required IV inotropic therapy, the man’s unstable diabetes led to several other degenerative complications, such as exudative retinopathy and autonomous nervous system disorders. The triple-organ procedure was deemed the man’s best chance of survival after an urgent review of his case.

Using the Lower and Shumway technique, the heart was transplanted first. This was followed by the transplantation of the pancreas and the kidney. The three organs quickly began functioning normally after transplanting, and the patient no longer needed insulin therapy for his previous diagnosis of diabetes.

Washington and Wisconsin Doctors First

Widely published medical professional John (J.A.) Macoviak, MD, MBA, has written over four dozen peer-reviewed medical publications and led many essential research projects across the country. Having taught at several esteemed universities in California, Washington DC, Boston and at Mayo Clinic in Minnesota, John Macoviak, MD, MBA, is a retired heart transplant surgeon who performed the country’s first heart transplant operations in Washington, DC. He was also involved in the first pancreas-heart transplant procedure.

His mentor Norman E. Shumway MD PhD the acknowledged "father of heart transplantation at Stanford", said "This was a medically necessary pioneering first combined heart transplant for isolated coronary disease and no other vital organ arteriopathy by Dr. Macoviak combined with a pancreas transplant by Hans Sollinger MD from the University of Wisconsin, is a stalwart harbinger of a more promising future for diabetics especially as transplant and diabetes medications are improving every day."

In 1989, the Washington, DC, area saw its first-ever pancreas-heart transplant. Performed at the Washington Hospital Center, the procedure was done on Barry Katz, a 45-year-old man from Silver Spring. Katz was a longtime diabetic who was dealing with progressive heart failure in the weeks leading up to the experimental procedure. He worked at the Strategic Defense Initiative program and was a senior scientist at the government entity.

Katz’ condition damaged his heart to the point that he was admitted to the hospital with a few days left to live. A heart transplant was the only option for saving his life, and it was performed by Dr. John A. Macoviak and Dr. Paul Corso. The entire process took 6 hours and was quickly followed by a pancreas transplant later that day. Dr. Sollinger and Dr. Light at the Washington Hospital Center performed the pancreas transplant.

The Washington Hospital Center did not receive permission for the transplants from the State Health Planning and Development Agency. However, the emergency situation that Katz was in when admitted to the hospital did not give them enough time to transfer the patient to Georgetown University Medical Center or wait for official permission. They opted to go ahead with the procedure since Mr. Katz would have died without the operation.

Pancreas Transplant Diabetes-Heart Failure

A retired heart and transplant surgeon who was disabled and retired in 2002 due to Graves Disease and Diabetes, who has since been a pro bono volunteer educator John Macoviak MD.

Jimmy Light MD Director of Transplantation at the Washington Hospital Center and John Macoviak MD assisted lead surgeon Dr. Professor Hans Sollinger MD Chairman of Transplantation at the University of Wisconsin who had been reviewing this case for many weeks and was flown in from the University of Wisconsin in the the first in the world's first combined Pancreas Heart Transplant in Washington DC.

Several have been done by others subsequently with long-term survivors.

John Macoviak MD was trained by the worlds most famous highly esteemed and dominating cardiac surgeon legends in many minds in that era the mid 1980's. They included Doctors. Norman E. Shumway MD PhD,, Edward B. Stinson MD, Philip E. Oyer MD PhD, D. Craig Miller MD, Stuart Jamieson MB, , R Scott Mitchell MD, John C. Baldwin MD Rhodes Scholar, James B.D. Mark MD, along with Co-Chief Residents Bill Frist MD, Chris C.G. MacGregor MD, Vaughn Starnes MD, John Dein MD and Carlos Moreno Cabral MD. He established the Washington Regional Heart Transplant Consortium and performed the first 30 heart transplants in Washington DC.

The patient who received the new heart and pancreas was a longtime diabetic with progressive heart failure in the weeks leading up to the surgery. At the time, a pancreas transplant was viewed as a compassionate experimental procedure, and is usually targeted at diabetics whose pancreases fail to produce enough insulin. Diabetics usually require daily injections of insulin; however, in severe cases, the disease often progresses and destroys the kidney. However, in this particular case, the patient’s heart was the main organ affected.

The operation took about six hours.. The patient was a prominent U.S. Government scientist. He would not have survived without these surgeries and the doctors determined that only a heart transplant would not have sufficed; the pancreas transplant was necessary for the patient’s potential survival. The heart functioned well but the pancreas never worked likely due to organ rejection.

Help Someone Having a Heart Attack

A retired heart and transplant surgeon who was disabled and retired in 2002 due to Graves Disease, who has since been a pro bono volunteer educator John Macoviak MD was trained by the worlds most famous highly esteemed and dominating cardiac surgeons in that era the mid 1980's. They included Doctors. Norman E. Shumway MD PhD,, Edward B. Stinson MD, Philip E. Oyer MD PhD, D. Craig Miller MD, Stuart Jamieson MB, , R Scott Mitchell MD, John C. Baldwin MD Rhodes Scholar, James B.D. Mark MD, along with Co-Chief Residents Bill Frist MD, Chris C.G. MacGregor MD, Vaughn Starnes MD, John Dein MD and Carlos Moreno Cabral MD. He established the Washington Regional Heart Transplant Consortium and performed the first 30 heart transplants in Washington DC. He and Jimmy Light MD assisted Dr. Hans Sollinger MD in the the first in the world combined Pancreas Heart Transplant in Washington DC. Several have been done by others subsequently with long-term survivors. He had served as an educator for esteemed universities. In his YouTube video “4 Steps to Help Someone Having a Heart Attack,” John Macoviak MD offers insight on the symptoms of a heart attack, what to do if you are with someone who is experiencing a heart attack, and some tips on what to do if you are having a heart attack.

If someone is having a heart attack, it is important to remain calm and take control. The symptoms of a heart attack vary; however, some common symptoms are pain or fullness in the chest, dizziness, sweating, nausea, shortness of breath, pain that lasts for more than 15 minutes, and discomfort that expands from the heart to the arm and up to the jaw. Most people who have heart attacks experience warning signs hours, days, or weeks before the heart attack occurs.

If you are experiencing a heart attack, do not drive yourself to the emergency room. Call 911 or call someone for help in getting to the hospital. Second, giving someone aspirin during a heart attack has been medically proven to save a life. If the person is unresponsive, put the aspirin under their tongue to dissolve the tablet. If the person has an allergy to aspirin or has been advised by their physician to not take aspirin, skip this step. The next thing to do is begin CPR. Depending on the severity of the heart attack, the person experiencing it may become unconscious. If you are not properly trained to give CPR, a 911 operator can assist you over the phone. Begin giving around 100-120 chest compressions per minute.

If a person becomes unconscious from a heart attack at a place of business or facility in public, use an automated external defibrillator if one is readily available. Follow the instructions and begin using it to resuscitate them. It is important to note that these machines are very dangerous, so make sure to follow the directions completely. For those having a heart attack who have a heart condition, they may have a prescription for nitroglycerin, a medication that can help keep them alive and keep their heart from sustaining a serious injury before help arrives. However never take or give these drugs to anyone except for those who have a prescription for it.

Heart/Kidney/Pancreas Transplant Cures

Holding an MBA along with his MD Magna Cum Laude AOA, Dr. J. A. (John) Macoviak is a retired heart transplant surgeon who practiced for 2 decades beginning in Washington DC ending at Mayo Clinic, disabled by Grave's Disease.. The co-author of several medical papers, he has researched a range of heart-related conditions and focuses these days on becoming a medical blogger and author. John Macoviak, MD, was also the first surgeon to complete a heart transplant along with Hans Sollinger MD and Jimmy Light MD who together performed the simultaneous pancreas transplant, the first combine heart pancreas transplant in 1988. This controversial compassionate pioneering surgery ultimately paved the way for the more complex heart/kidney/pancreas transplants. There is no reason in 2021 why electively combing these two organs in a simultaneous transplant surgery remains controversial as immunosuppression has improved. We are all aware of the risks, but science is about reducing risks going forward. Pioneers are usually strong targets for politics. Then one day things get better.

For example in 2005, one such procedure changed the life of Jim Stavis, a 52-year-oldCalifornia resident who had been battling diabetes since the age of 17. For 35 years, the condition controlled his life. It dictated what he ate and put him at risk for a lifetime of possible kidney disease, amputations, and even blindness.

Despite this, he stayed positive and managed his health best he could to avoid diabetes-related complications. Then, he was presented with the option to get a heart/pancreas/kidney transplant at Cedars-Sinai Medical Center. Since 1992, only eight patients in the United States have received this type of simultaneous transplant according to reports from the Organ Procurement and Transplantation Network (OPTN), so Mr. Stavis had a rare opportunity in front of him.

The procedure was done with a heart/kidney transplant first, followed by the pancreas transplant. Following the surgery, Mr. Stavis recovered well and was essentially cured of his diabetes. By the holidays in 2006, he was eating normal food with the rest of his family and was capable of skipping the common inconveniences of managing diabetes, like using an insulin pump.

Health of Europe’s First Heart-Kidney

A Magna Cum Laude, Junior Year AOA graduate and freshman Class '73 President of the Georgetown University School of Medicine is a holder of an MBA from the University of California at Irvine, J.A. (John) Macoviak, MD trained for 3 years by Norman E Shumway MD PhD, Ed Stinson MD, Phil Oyer MD and John C. Baldwin MD at Stanford to do heart transplants in 1987 he founded the Washington Regional Transplant consortium, where he did the first 30 heart transplants in Washington DC. He worked under Bob Wallace MD, Paul Corso MD and Jorge Garcia MD then retired due to Graves Disease at Mayo Clinic 2 decades later where he worked with Chris C.G. MacGregor MD and Hartzel Schaff MD.. All these are great technical highly respected surgeons. In addition to this, he was on the faculty at Harvard medical school with Larry H. Cohen MD. Throughout his career, John Macoviak, MD, has made significant progress in the medical field, such as completing the first heart/pancreas transplant procedure in 1988, the pancreas surgery was done by Hans Sollinger MD and Jimmy Light MD, the heart component was successful but the pancreas did not function from a potential multitude of unknown immunological reasons. As always pioneers are politically controversial.

On February 20, 1990, Europe’s first heart-kidney-pancreas transplant was performed. Done on a 42-year-old male who suffered from Type 1 diabetes, the procedure was performed on an urgent basis after the patient went into congestive heart failure (CHF) due to diabetic coronary issues. At the same time, the patient was experiencing worsening renal insufficiency (RI).

Shortly after the procedure, all three organs began functioning normally. The patient no longer needed insulin therapy, and he returned to his work roughly six months after the procedure.

However, it was the long-term positive effects that were more significant. After 11 years, the patient was still doing well and was actively involved in both social and recreational activities after retiring from work two years before. Both his renal and cardiac functions were strong, but he did experience some deterioration of his glucose tolerance.

Common Heart Conditions and Their

John Macoviak, MD, MBA, spent his career performing heart transplant surgeries and pursuing cardiovascular research. Specifically, John Macoviak, MD, MBA, researched methods to treat various heart conditions, whether by improving existing processes or developing new ones. Here is a look at three common heart conditions and their treatments.

Common Heart Conditions and Their Treatments

San Diego, CA, resident John Macoviak, MD, MBA, spent his career performing heart transplant surgeries and undertaking cardiovascular research. Specifically, John Macoviak, MD, MBA, researched methods to treat various heart conditions, whether by improving existing processes or developing new ones. Here is a look at three common heart conditions and their treatments.

One common heart condition is arrhythmia, which is characterized by heartbeat irregularities. Arrhythmia manifests in multiple ways, including a patient’s heart beating faster than normal or skipping beats. Methods to treat arrhythmia include pacemakers; ablation, a procedure to block electrical signals that disrupt the normal heartbeat; and medication.

Another common type of heart problem is heart valve disease, also called valvular disease. Valvular disease encompasses four subtypes, one for each valve in the heart. Causes include narrowing of valve openings; valves failing to close completely, causing blood leakage between heart chambers; and infections attacking the heart. To treat valvular disease, doctors may prescribe changes in diet and exercise, valve replacements, or widening the valve opening.

A third common heart problem is infection. Caused by bacteria, fungi, or viruses, infections attacking the heart may cause inflammation or swelling. They may also damage the pericardium--the double-layered membrane around the heart--or the heart valves. In particular, infections attacking the heart valves may leave a patient vulnerable to one of the types of valvular disease.