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.