Two Texas surgical teams recently performed an extremely rare, lungs-and-liver double organ transplant at the University of Texas (UT) Southwestern Medical Center’s William P. Clements Jr. University Hospital. The operation, the first successfully completed in North Texas and only the 75th such surgery in the United States, gave 25-year-old Josiah Ferrell from Gainesville — a cystic fibrosis (CF) patient — a second chance.
Liver disease is present in about 25 percent of CF patients, and only 8 percent develop liver cirrhosis. Despite managing his disease according to all recommendations, Ferrell’s lungs and liver needed replacing, but the chance of getting a double organ transplant is low.
“It’s rare for someone to need both these organs and, at the same time, to be healthy enough to tolerate the surgery,” Dr. Fernando Torres, a professor of Internal Medicine and medical director of Lung Transplantation at UT Southwestern, said in a press release.
For the past two years, Ferrell was entirely dependent on an oxygen tank. “It limited what I could do. I basically never left the house. A portable machine wouldn’t supply enough oxygen,” he said.
On Jan. 12, Ferrell was surprised to learn that a donor for both organs had been found. The next morning he was lying on the operating table.
The double organ transplant surgery took 12 hours and was performed by two surgical teams. To avoid putting Ferrell on a heart-lung bypass machine, the surgeons decided to replace one lung at a time. “The lungs were implanted without much of the difficulty we had anticipated and planned for, and the transition from lung to liver transplant was seamless,” said Dr. Michael Wait, who performed the lung transplant, a professor of Cardiovascular and Thoracic Surgery at UT Southwestern and chief of the Cardiovascular and Thoracic Surgery Service at the hospital. “Everything had to be aligned for this to happen — the two transplant teams, the right patient, the right donor.”
“The surgery had to be carefully planned and coordinated. You have two different surgical teams – the thoracic team putting in the lungs and the abdominal team putting in the liver – and it all has to be carefully thought out in advance,” added Dr. Malcolm MacConmara, an assistant professor of Surgery who performed the liver transplant. “This surgery showcases the best of what we have at UT Southwestern. We communicated exceptionally well in the planning. It’s an example of a well-thought-out, well-executed plan between the cardiothoracic surgery team and the abdominal surgery team, as well as all the other professionals involved.”
Ferrell’s recovery follows a steady path and he has returned home, but will spend the next nine months in frequent follow-ups and undergo a multitude of tests and medical adjustments. He is, however grateful, for the chance to receive the organs, and looks forward to living life more fully.
“We had our first real family outing since the transplant — dinner at Olive Garden. I had really been looking forward to that. It was my first restaurant meal since 2014. I’d like to go to Target,” Ferrell said.
“He’s laughing and cracking jokes now. He’s upbeat,” said his father, John Ferrell. “He’s gotten back to being himself.”