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My Toughest Case
As a transplant surgeon, I knew that organs can survive outside the body for up to ten hours before going
into a recipient. My idea was to use transplant techniques with this patient. Wed clamp the arteries and
take out her abdominal organs, and put them in a cold-preservation solution. Then wed cut out the
tumor in the arteries, reconstruct her blood vessels using synthetic materials, replace the organs, and
reconnect the arteries. It would be like an organ transplant with the same person as donor and recipient.
Ive done a number of multiple-organ transplants, but this exact surgery had never been done before. I
told the patient there would be unknown risks involved, and that the procedure would be very
dangerous. Because we would be disconnecting the abdominal aorta, which goes to the spine, there was
a chance of paralysis. Blood connections could leak or clot. What if you take all the organs out, then find
that you cant reconstruct the blood vessels?
The initial part of the surgery took six hours. We were trying to create a situation where the entire organ
block is up in the air, meaning all the connections are cut and its ready to move. First, I divided the
esophagus from the stomach. The large bowel had to be cut in the middle portion. Part of the colon came
out. After we cut the arteries, we moved the organ block into preservation solution on the back table.
Even though organs can survive in the ice box for up to ten hours, the patient cant survive without
organs for that long. Our assumption was probably six hours, but we didnt want to reach that point.
Transplant Surgeon Tomoaki Kato on his Most Difficult Case Removing a Tumor - Best Doctors 2010 -- New York Magazine
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Table of Contents: Jun 14, 2010 issue of New York | Subscribe!