UR Medicine Strong Memorial Hospital completes dual kidney-heart transplant

por John R. Fischer, Senior Reporter | April 11, 2023
Operating Room
UR Medicine Strong Memorial Hospital performed a dual heart-kidney transplant in a single day in 14 hours. (Photo courtesy of University of Rochester Medical Center)
Doctors at UR Medicine Strong Memorial Hospital, in Rochester, New York, performed 14 hours of surgeries in a single day to implant both a kidney and heart into a 32-year-old woman.

Prior to her surgery, Ashley Cuylear, a nursing student at the University of Rochester who has a 16-year-old daughter, was sick for over a decade, having been diagnosed at 22 with lupus nephritis, a hereditary autoimmune disorder that causes the body to attack its own organs, often starting with the kidneys and later the heart.

The irreversible damage to her kidney required her to undergo dialysis therapy. When the disease caught up to her heart, Cuylear ended up in the ED on extracorporeal membrane oxygenation to provide her body with oxygen-rich blood.
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Strong Memorial Hospital, which has performed 135 dual-organ cases and is the only center in upstate New York that performs heart and liver transplants, as well as kidney and pancreas, performed both procedures on October 28. Over 250 clinical and support staff from 20 departments cared for Ashley before, during and after her surgeries.

“A dual-organ transplant requires tremendous coordination and communication between the two transplant teams — heart and kidney in this case. We started working on this as soon as Ashley was added to the waiting list for the heart transplant,” said Dr. Karen Pineda-Solis, kidney transplant surgeon, in a statement on April 9.

The Finger Lakes Donor Recovery Network, the organ procurement organization affiliated with the University of Rochester Medical Center, and other Upstate New York hospitals coordinated the donations.

The heart and kidney transplant teams together reviewed every step of the surgeries, testing and medications for preventing organ rejection, and spent eight hours co-developing plans to address potential emergencies or challenges. The heart was transplanted first and started beating immediately, with doctors closely monitoring it to ensure it was strong and that Cuylear was stable. Four hours later, she underwent a three-hour kidney transplant.

“We had a great anesthesia team that followed her respiration and medications to protect organ function. They are very detail-oriented and that allows surgeons to focus on the transplant,” said cardiac transplant surgeon Dr. Katherine Wood.

More than 104,000 patients in the U.S. require an organ transplant, far exceeding the number of donations available annually, according to the Finger Lakes Donor Recovery Network. Seventeen deaths occur daily due to a lack of available organs.

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