Recipient, 54, Doing Well More Than Three Months after Combined Operation
Keith Overcash is feeling better than good these days.
“I feel wonderful, especially considering where I was just three months ago,” said Overcash, a 54-year-old Denton resident who in early September underwent the first heart and kidney transplant performed at Wake Forest Baptist Medical Center.
In the procedure that spanned more than 18 hours, Overcash received both organs from the same donor. The heart transplant was done first, by Edward Kincaid, M.D., associate professor of cardiothoracic surgery. After that was judged successful, the kidney operation was performed by Jeffrey Rogers, M.D., professor of surgery.
Overcash underwent the combined transplant approximately a year after being referred to Wake Forest Baptist’s Heart and Vascular Center by a cardiologist at the regional hospital in Salisbury.
“When he first came here he was in cardiogenic shock, which is essentially life-threatening heart failure,” said Barbara Pisani, D.O., professor of cardiology at Wake Forest Baptist, who has directed Overcash’s care at the Medical Center in conjunction with Ebere O. Chukwu, M.B.B.S., assistant professor of cardiology.
Overcash was first diagnosed with heart failure – the condition when the heart is unable to pump sufficient blood to the body’s organs – in 1995 when he was in the Army. He remained on active duty until 2006, when he retired as a command sergeant major after 26 years in uniform. He then went to work for the Department of Veteran Affairs but his heart condition and related health issues forced him to leave that job in February 2012, and he spent most of the next two and a half years bedridden and in and out of the hospital.
“There was no doubt in my mind that I was dying,” Overcash said of that time.
When Overcash was admitted to Wake Forest Baptist in late September 2014 he was first treated with a temporary ventricular assist device (VAD), a mechanical pump that provides short-term circulatory support of the heart’s pumping function. He then had a more durable VAD implanted because he was too ill to survive to a heart transplant without mechanical support. Once his health improved, he was evaluated for the transplant.
“But he had severe kidney damage and it was feared that even if he got a heart transplant his kidney function would continue to deteriorate, and he would require dialysis,” explained Betty Crandall, R.N., administrative director of transplant services at Wake Forest Baptist. “And outcomes for heart transplant recipients on dialysis are less than optimal.”
Overcash was then evaluated for a heart-kidney transplant and it was determined that he was a candidate. He was listed for the combined transplant with the United Network for Organ Sharing, the nonprofit organization that manages the nation’s organ transplant system, in the spring of 2015. Suitable donor organs became available in less than six months, and Overcash underwent the combined procedure on Sept. 1.
Was he worried about being Wake Forest Baptist’s first heart-kidney transplant patient?
“I was more excited than anything else,” Overcash said. “From the very first day I met the team there I was impressed with the dedication they showed and very confident in their ability.”
Overcash is now living at home but returns to Wake Forest Baptist three days a week for exercise therapy. A licensed Pentecostal Holiness minister, he is preaching occasionally and has applied to be a volunteer at the Medical Center.
“I’m probably doing better than anybody expected,” he said. “And I want to do whatever I can to help other people.”
While the first combined heart-kidney transplant in the United States was performed in 1989, the procedure is still uncommon, with fewer than 100 done in the country each year.
Pisani said Overcash’s combined transplant illustrates the high level of care provided at Wake Forest Baptist.
“You can get very sophisticated care right here in Winston-Salem,” she said. “You don’t have to leave the area to have access to advanced therapy for heart failure, kidney disease or other life-threatening conditions.”
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