Curtis Jackson was living his dream life — a loving and supportive wife, three wonderful kids, and a future that looked as bright as could be.

Then, one day, without warning, the dream was shattered.

At only 46, Curtis was diagnosed with cholangiocarcinoma, one of the deadliest and most aggressive forms of cancer. It's a silent killer that strikes the liver. It is often diagnosed in later stages, leaving patients with few treatment options and little time to live.

The Jackson family turned to Mayo Clinic, where a team of experts fought the cancer with a weapon rarely used in the battle against this aggressive form of cancer.

Watch: A rare cancer. A rare weapon. Curtis Jackson's inspiring story of survival.

Journalists: Broadcast-quality video (2:17) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

The rare cancer

Years before his cancer diagnosis, Curtis was diagnosed with primary sclerosing cholangitis (PSC). PSC is a chronic liver disease that causes inflammation and scarring to the bile ducts, which work with the liver to help with digestion.

PSC put the Arizona man at higher risk for liver cancer, requiring him to get regular diagnostic screenings. As with most forms of cancer, but particularly cholangiocarcinoma, doctors say early detection is key to improving patient outcomes.

However, with cholangiocarcinoma, there are often no warning signs or symptoms alerting patients of the need to consult with their doctor about getting screened, until it's too late. In Curtis' case, the cholangiocarcinoma was detected in one of his routine screenings at Mayo Clinic, which doctors say likely helped save his life.

"It's a very rare cancer that tends to grow unnoticed," says Dr. Tanios Bekaii-Saab, an oncologist with the Mayo Clinic Comprehensive Cancer Center in Arizona. "If the cancer gets to the point where it's too advanced for surgery or transplantation, universally this is a noncurative or noncurable cancer."

The rare weapon

Doctors say a liver transplant can sometimes be an option for some patients. However, not many transplant centers perform liver transplants on patients diagnosed with cholangiocarcinoma. Mayo Clinic is one of the few centers that do offer liver transplantation for some patients who meet certain criteria.

In Curtis' case, doctors at Mayo Clinic determined a liver transplant was his best chance for survival.

"It is a unique form of therapy that is based on research that started at Mayo Clinic in Rochester, Minnesota," says Dr. Bashar Aqel, director of the Mayo Clinic Transplant Center in Arizona.

"We developed some protocols that helped us improve the outcome of transplant in these patients, and without these protocols, a lot of patients with this type of cancer would not make it to transplant," says Dr. Aqel.

The treatment

Curtis first underwent chemotherapy and radiation at Mayo Clinic. He was then placed on the liver transplant waiting list for a donor organ. While waiting, Curtis says he kept his focus on his family.

"I spent all the time I could with my wife and kids, like basketball practices, homework, anything we could do to help our kids," says Curtis.

When Curtis got the call a donor organ was found, he immediately reported to Mayo Clinic to undergo his lifesaving liver transplant. The surgery was a success. Four weeks later, Curtis was back at home with family recovering well and feeling a deep sense of gratitude for his organ donor and his team at Mayo Clinic.

"Thank you because now I get to see my daughters get married, go to college, I get to see my son live his dreams and go to college and get married," says Curtis. "I get to live and grow old with my wife. I can't say this enough to everyone, 'thank you.'"

"We're already observing excellent function from Curtis' new liver, with the majority of his liver tests returning normal results," says Dr. Aqel. "His recovery has been remarkably swift and impressive."

"A lot of love goes out to the people in that family," says Gwyn Jackson, Curtis' oldest daughter in reference to the organ donor's family. "They allowed us to have our dad back and we're so grateful because we love him so much."

Doctors at Mayo Clinic are monitoring Curtis' progress closely. Meanwhile, Curtis' future is back to looking bright, only now with even deeper gratitude in his heart.

"This truly is the gift of life," says Curtis.

Related stories:

• (VIDEO) Breathing easy thanks to the gift of life and new Mayo Clinic Lung Transplant Program in Arizona
• Breaking barriers: Helping Native Americans in need get the gift of life
• Jessie’s Journey
• (VIDEO) Harnessing the power of innovation and a patient’s will to survive

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Craig Scherer takes a deep breath and a bold step into his second chance at life

Lung disease is a condition that affects millions of people worldwide. Some of those diseases, like chronic obstructive pulmonary disease, or COPD, are among the top leading causes of death globally.

COPD alone affects over 16 million people, like Arizona resident Craig Schuerer. Craig got treatments to manage his condition, but there's no cure. The disease is progressive, meaning it gets worse over time, making it harder and harder for a person to breathe.

Craig's disease progressed until treatments no longer worked, leaving him gasping for air and facing death. Doctors said his only hope for survival was a lung transplant. 

Craig turned to Mayo Clinic in Phoenix, where doctors just launched a new multidisciplinary, specialized lung transplant program. Craig became the new program's first patient, and today he is breathing easy.

Watch: Breathing easy thanks to the gift of life and Mayo Clinic's new lung transplant program in Arizona

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It was love at first sight for Craig and Nanci Scherer.

They met at a little league game in the spring of 1992. Eight months later, they were married. This year, Craig and Nanci celebrated their 32nd anniversary. 

Their smiles today are just as radiant as on their wedding day.

Happiness turns to heartache

The couple raised four children. Their family grew to include 14 grandchildren and six great-grandchildren. They planned for retirement and looked forward to the day when they could travel and enjoy their future together.

But when Craig turned 60, life took a sharp turn. He was diagnosed with chronic obstructive pulmonary disease. COPD is a progressive disease that causes damage to the lungs, making it hard to breathe. Treatments can help manage the disease, but there's no cure. As the disease continues its silent assault, quality of life often slowly slips away. 

"I couldn't do things, and even if I could do things, I didn't have the strength to do it or the stamina because my lungs would wear out," says Craig.

Craig's COPD continued to get worse. Eventually he couldn't breathe, walk or even talk. "It was silent at our house. We didn't talk because he couldn't talk. He didn't have the oxygen," says Nanci. "We lived in silence and isolation."

Last hope for survival

Eventually, Craig reached end-stage lung disease. Treatments no longer worked and his health continued to decline. Craig was left with only one last hope for survival, a lung transplant. Craig and Nanci turned to Mayo Clinic in Arizona.

"We see this with patients, when there are no other options, no medical interventions you can do at that point," says Dr. Jonathan D'Cunha, surgical director of the Mayo Clinic Lung Transplant Program in Arizona transplant center

For six years, Dr. D'Cunha had been working on building a multidisciplinary team of medical and surgical experts to create a new lung transplant program at Mayo Clinic in Arizona. 

The transplant center is the largest in the country, performing more adult solid organ transplants than any other center in the U.S. The addition of the lung transplant program establishes Mayo Clinic in Arizona as a comprehensive transplant destination medical center.

The program will provide transplantation for the full range of patients with end-stage lung disease. "This is the beginning of a remarkable new era for lung transplantation in Arizona," says Dr. D'Cunha. "We are excited and honored to offer patients and families renewed hope and a second chance at life through Mayo's unrivaled expertise in comprehensive adult organ transplant care."

Craig became the new program's first patient to receive a lung transplant.

Giving the gift of life

On May 30, 2025, Dr. D'Cunha led a team of surgeons in performing Craig's lung transplant. The surgery was a success, and soon after, Craig was slowly starting to breathe with his new lungs. 

"It is surreal to be able to breathe and not gasp for air when I talk," says Craig, who was up and walking within days of surgery. "I told the doctors when I got here that I will do whatever it takes. I'm 100% committed. If you want me to walk six times a day, I'll walk seven," says Craig.

"He did phenomenal," says Dr. D'Cunha. "His optimism and energy he brought with him is absolutely critical because the stronger you are going into these big operations, the better you are on the other side.

"I'm very proud of Craig. He always amazing me throughout the journey of transplant," says Ashraf Omar, M.B., B.Ch., medical director of the transplant program. "He is a special person. Motivation is the cornerstone of his success."

A fighter's farewell

Two and a half weeks after his transplant, Craig was heading home. The transplant team bid him farewell with a victory celebration with pom-poms waving and confetti raining down.

Watch: Craig crosses the finish line of his journey with a breathtaking victory celebration from Mayo's transplant team.

A few days later, on June 23, Craig returned to Mayo to join his transplant team for a news conference announcing the official launch of the lung transplant program.

It was also Craig's 67th birthday.

In honor of his organ donor and the donor family, Craig used his new lungs to blow out the candles on his birthday cake.

Watch: Craig's heartfelt moment in honor of the gift of life

Craig and Nanci are back at home and looking forward to beginning the next chapter of their story. 

"I have a lot of life left to live in me. Everything is a motivator — my wife, my kids, my grandkids, my health," says Craig. "Before, I had no quality of life and couldn't do anything. Now, there's nothing I can't accomplish." 

Related stories:

• Mayo Clinic in Arizona announces launch of new lung transplant program offering hope and restored function to patients facing advanced lung disease
• Lung Transplant Program
• Breathing easier with COPD

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Sue Baker started having issues with her heart in 2015. By 2019, she began experiencing heart failure. Living in Southeast Georgia, her condition landed her in the hospital seven times before the last visit led to her being transferred to Mayo Clinic in Florida, nearly 90 minutes away, critically ill.

"She was really sick — in cardiogenic shock, intubated, connected to a breathing machine — she was not going to make it," says Dr. Parag Patel, a Mayo Clinic transplant cardiologist. "She only had three to six months to live, and we needed to act fast."

Watch: Sue Baker's story

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Sue's situation had become dire. She was presented with two options: enter hospice care or have a left ventricular assist device (LVAD) implanted to serve as a bridge to a heart transplant. While she chose the LVAD to buy more time, by 2023 she was experiencing dangerous heart rhythms and other challenges.

Complicating matters, her body was producing more antibodies, making it increasingly difficult to find a suitable transplant donor.

"It was devastating to know that I'm actually going to die," says Sue. Still, she did not lose hope. "You just grab hold of God and keep praying," she says.

Sue's care team also remained determined to help her hold on. They explored an innovative approach — called Heart After Liver Transplant with a Domino Liver to another patient (HALT-D) — that had shown success in patients with similar antibody counts.

HALT-D, however, had never been attempted on someone with a heart pump like hers. This procedure would be a first for Mayo Clinic, at any of its transplant sites.

Although Sue's liver was healthy, she would need to get not just a heart transplant but also a donor liver to help remove the antibodies from her body and reduce the risk of her new heart being rejected. This meant a rare and complex domino transplant, involving both a liver and a heart, where Sue's liver would also become part of the donor chain.

"We take the liver of the patient who's receiving the heart after liver, and we take that liver and we put it into another recipient so that we do not waste an organ," says Patel.

Preparing for this complex procedure involved extensive multidisciplinary collaboration between a variety of Mayo Clinic departments. Sue spent months in the hospital, waiting for a match. During her wait, fellow patients and staff began calling her "mama" for the care and support she provided everyone else, despite her own challenges.

"We get to know each other and kind of help each other out," says Sue. "That was a lot of healing and helpfulness there."

"Sue not only helped people on the floor, but she's helped other patients who didn't have an opportunity" for transplant, says Patel.

Finally, in September 2024, the domino transplant was performed successfully.

Today, Sue is on the path to recovery, growing stronger each day. Her motivation to live is fueled by the desire to honor her donor, whose gift has given her a second chance at life.

"I would love to thank and meet the family," says Sue. "I'm not going to sit back and do nothing. That person will always be special."

Her story is a testament to the power of medical innovation, the dedication of healthcare professionals, and the resilience of the human spirit.

"I love her, and I appreciate the doctors and all the nurses that have been so loving and caring for Sue,” says Charlene Taylor, Sue's caretaker.

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First patient celebrates 67th birthday using his new lungs to blow out candles on his birthday cake in honor of receiving the gift of life

PHOENIX — Mayo Clinic in Arizona announced it has added lung transplantation to its nationally recognized solid organ transplant program. The program delivers world-class care to critically ill patients battling end-stage lung disease who need a lung transplant to survive and restore their quality of life. 

The new Mayo Clinic Lung Transplant Program in Arizona offers a multidisciplinary team of medical and surgical experts in the Southwest, supported by clinical innovation from across Mayo Clinic, bringing unparalleled experience and the latest in research-driven care to every patient.

"With the launch of our new lung transplant program, we are reinforcing our commitment to providing category-of-one care to patients with serious and complex medical needs. This new program strengthens our nationally acclaimed solid organ transplant program in Arizona, giving more patients access to the transformative gift of renewed life," says Richard Gray, M.D., CEO of Mayo Clinic in Arizona. 

Jonathan D'Cunha, M.D., Ph.D., surgical director of the transplant program, says the team of experts will provide transplantation for the full range of patients with end-stage lung disease.

"This is the beginning of a remarkable new era for lung transplantation in Arizona," says Dr. D'Cunha. "We are excited and honored to offer patients and families renewed hope and a second chance at life through Mayo's unrivaled expertise in comprehensive adult organ transplant care."

Craig Scherer became the new program's first patient to undergo a lifesaving lung transplant on May 30. Soon after surgery, Craig was already beginning to breathe slowly on his own for the first time in years. He was discharged June 18 and is now back at home.

"It is surreal to be able to breathe again and not gasp for air. The reality has not even set in yet. I'm putting a lot of thought into finding the right words to express how deeply grateful I am for this gift," says Craig. 

Craig is one of the millions worldwide who have suffered loss of lung function due to chronic respiratory diseases, including chronic obstructive pulmonary disease, or COPD. 

Over the years, the progressive disease slowly robbed the Arizona man of his ability to breathe, leaving him dependent on oxygen tanks for survival. "I couldn't go places, couldn't do things. My quality of life was zero. I was always very anxious and afraid the tanks were going to run out," says Craig. 

Chronic lower respiratory diseases (CLRDs) are the fifth-leading killer in the U.S., according to a 2024 report from the Centers for Disease Control and Prevention. The report cited CLRD as the cause of death for approximately 145,000 people in the U.S. in one year. 

Craig's wife, Nanci, says he also lost the ability to speak. "He didn't have the oxygen to talk. We lived in silence and isolated," says Nanci. The couple has been married for 32 years.

Eventually, Craig reached the final stage of lung failure. Oxygen tanks were no longer enough to help him breathe. "We were truly desperate. We were down to weeks," says Nanci. "I didn't think he would make it to his next birthday." 

Dr. D'Cunha led the team of surgical specialists that performed Craig's transplant. He said patients like Craig all too often reach a point where supplemental oxygen is no longer sufficient to meet their respiratory needs.

"There are no medical interventions at that point. They have run out of time," he says. "Lung transplant becomes the patient's only option. In Craig's case, without the transplant, it likely would have resulted in his death."

Three weeks after his transplant, with daily physical therapy, Craig is back to walking and talking like he did years ago. "It is not an easy journey," says Dr. D'Cunha. "But it's a journey that gives patients like Craig hope — to see his grandchildren, the next milestone, or whatever his goals may be."

Ashraf Omar, M.B., B.Ch., medical director of the lung transplant program, took note of Craig's determination from the start. "I'm proud of Craig. He has always amazed me," says Dr. Omar. "He's a special person. Motivation is the cornerstone of his success." 

Mayo Clinic's new program in Arizona will offer the latest advancements in lung transplant innovation, including ex vivo lung perfusion (EVLP), which is considered one of the most transformative breakthroughs in lung transplantation in recent years. EVLP improves the success of lung transplantation by helping preserve and evaluate donor lungs prior to transplant.  

Mayo Clinic Transplant Center, with integrated programs in Minnesota, Florida and Arizona, is the nation's largest provider of adult solid organ transplantation. Mayo Clinic in Arizona is on target to surpass its 2024 record number of nearly 900 transplants.

In the first week of June alone, the Arizona program successfully performed a record-breaking 36 transplants. The addition of the lung transplant program establishes Mayo Clinic in Arizona as a comprehensive transplant destination medical center.

"As the leader in organ transplantation in the country, we are committed to our vision where no patient dies while waiting for a lifesaving transplant," says Bashar Aqel, M.D., director of the Mayo Clinic Transplant Center in Arizona. "Our new program meets an urgent need for so many patients fighting to survive end-stage lung disease."

On June 23, Craig celebrated his 67^th birthday. He joined the team of surgeons who performed his lifesaving transplant for a news conference announcing the launch of the new transplantation program.  

The highlight of the event came when Craig addressed the crowd sharing what the transplant means to him. "These lungs are my 67^th birthday gift," said Craig, his hands resting on his chest. "This is the best birthday gift I could get in the world. It gave me life." 

Craig also expressed his gratitude for the staff at Mayo, the doctors, his family, his organ donor and the donor's family. "My heart goes out to the family. One day I hope I get to communicate my gratitude to them for giving me life. Most people don't get a second chance. I do," said Craig.

Dr. D'Cunha lit candles on a birthday cake for Craig in the shape of a set of lungs. In honor of the gift of life, Craig used his new lungs to blow out the candles with one single breath. Watch the emotional moment that was met with cheers and applause in recognition of the gift of life.

Craig and Nanci returned home to spend the rest of his birthday with family. Together they share four children, 14 grandchildren and six great-grandchildren.  

"I have a lot of life left to live in me. Everything is a motivator — my wife, my kids, my grandkids, my health," says Craig. "Before, I had no quality of life and couldn't do anything. Now there’s nothing I can't accomplish."

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About Mayo Clinic 
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Marty Velasco Hames, Mayo Clinic Communications, newsbureau@mayo.edu     

Additional resources:   

• Press kit including b-roll and interviews available here for download.

• For more information about lung transplantation and referrals, visit Mayo Clinic Lung Transplant Program in Arizona or call 480-342-1010.

• Consider giving the gift of life. Learn more about how you can become an organ donor.

• Visit the Mayo Clinic News Network for additional Mayo Clinic news. 

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ROCHESTER, Minn. — A new discovery by Mayo Clinic researchers could mean more donor hearts are available for heart transplant, giving more people a second chance at life.

In findings published in Nature Cardiovascular Research, a team led by Mayo Clinic cardiac surgeon Paul Tang, M.D., Ph.D., identified a biological process that contributes to donor heart injury during cold storage. The researchers found that a drug already used to treat heart conditions can prevent this damage.

Heart transplantation is the most effective treatment for end-stage heart failure, yet fewer than half of donor hearts are ultimately used. One major reason is the relatively short window for transplanting a donated heart into a patient, due to concerns over low donor heart function that comes from leaving a heart in cold storage too long.  

Why donor hearts deteriorate in cold storage

Although cold storage slows metabolism and helps preserve tissue, prolonged exposure to cold storage conditions can lead to molecular changes that compromise how well the heart performs after transplant. One complication is called primary graft dysfunction, in which the transplanted heart cannot pump blood effectively after surgery. This may affect up to 20% of recipients to varying degrees.

To investigate why this damage occurs, the researchers focused on a protein inside heart cells called the mineralocorticoid receptor, which plays a role in how cells respond to stress. During cold storage, they found that this protein undergoes a process in which the protein clumps together in a way that harms the heart cells, called liquid-liquid phase separation. This process promotes cardiac damage from increased inflammation and cell death, making the heart less likely to function well after transplant.

Preventing damage with a common drug

To test whether the process could be prevented, the researchers treated donor hearts with a drug called canrenone, which blocks mineralocorticoid receptor activity. In human donor hearts stored beyond the typical timeframe, treatment with the drug nearly tripled their pumping strength compared to hearts stored without it. The hearts also showed better blood flow and fewer signs of cell injury. The findings suggest canrenone may help extend the safe storage period for donor hearts by improving the heart’s pumping strength to increase chances of a successful transplant.

"As a cardiovascular surgeon, I’ve personally experienced in the operating room how every additional hour of preservation can impact the likelihood of whether a donor heart can return to normal function after transplantation," Dr. Tang says. "This discovery may give us a new tool to preserve heart function for longer during storage, improve transplant outcomes and enhance patient access to lifesaving transplants."

The study's findings also have the potential to improve the preservation of other transplantable organs. Similar protein clustering was observed in donor kidneys, lungs and livers during cold storage. This suggests that the same strategy may help expand transplant options across multiple organ systems.

Mayo Clinic collaborated with the University of Michigan on this research. Review the study for a complete list of authors, disclosures and funding. 

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About Mayo Clinic 
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news. 

Media contact:  

• Susan Murphy, Mayo Clinic Communications, newsbureau@mayo.edu 

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Knowing Mayo Clinic patient Brady Larson would miss his college graduation, his Mayo Clinic care team quickly stepped in to create his own special graduation. 

Brady, 20, was supposed to walk across the stage and receive his diploma at Mitchell Institute of Technology in Mitchell, South Dakota, on Friday, May 9. Instead, he was more than 300 miles away at Mayo Clinic preparing for his upcoming bone marrow transplant.

Watch: Graduation walk for Mayo Clinic patient, Brady Larson

Determined to ensure Brady was able to celebrate the big day, his care team organized a graduation walk-through ceremony for Brady in the hospital hallway. Doctors, nurses and others cheered him on as he walked to the song "Pomp and Circumstance," clutching a graduation cap decoration and sporting a white lab coat. A celebration followed with lime green cupcakes – his school color. 

Brady has severe aplastic anemia and needs a bone marrow transplant. He didn’t have to look far for a donor. His 15-year-old sister, Brooklyn, donated to help her big brother.

Brady graduated with a degree in agricultural business and plans to continue the family's legacy of farming in Letcher, South Dakota. Learn more about becoming a bone marrow donor.

Related post:

• Mayo Clinic Minute: Become an organ donor and save lives

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ROCHESTER, Minn. — Simultaneous bariatric surgery and liver transplant for patients who are severely obese is safe and improves long-term health outcomes, according to a recent Mayo Clinic study. This combined approach offers a needed solution for these patients who are often denied a lifesaving liver transplant due to their weight.

The 10-year study, published in the Journal of Hepatology, compared patients who received only a liver transplant with those who underwent both a liver transplant and bariatric surgery.

The combined approach resulted in sustained weight loss, reduced risk of type 2 diabetes and lower risk of fatty liver disease recurrence. Importantly, the combined procedure posed no additional risks compared to liver transplant alone.

"We've been amazed by the transformation our patients experience," says Julie Heimbach, M.D., director of Mayo Clinic Transplant Center in Minnesota and the study's senior author. "This dual approach prevents long-term obesity complications like diabetes, heart disease and cancer, while also preventing fatty liver disease recurrence."

How obesity and liver disease are connected

The percentage of liver transplant candidates in the U.S. with obesity continues to climb, with more than 41% of candidates having a body mass index above 30 in 2022. Obesity puts people at risk of developing metabolic dysfunction-associated steatotic liver disease, or MASLD, formerly known as nonalcoholic fatty liver disease. It's a condition where excess fat accumulates in the liver, which can lead to inflammation, scarring and advanced liver disease. Patients with a body mass index of 40 are more likely to be denied a transplant due to their weight.

"Since MASLD is a leading cause of liver failure, it only makes sense to protect the precious, lifegiving new liver from the same damage that led to the patient needing a transplant in the first place. Safely combining the two procedures protects the transplanted liver and can provide profound health benefits to these patients," says Todd Kellogg, M.D., Mayo Clinic bariatric surgeon and the study's co-author.

What about using new prescription medications for weight loss?

New weight loss medications, such as GLP-1s, are being used to help some pre-transplant and post-transplant patients manage their weight. Still, Mayo Clinic experts say bariatric surgery remains an important option for patients with severe obesity due to its safety, proven effectiveness and lasting results. Another recent Mayo study related to kidney transplant patients supports this.

"The patients that we're talking about really have a significant amount of extra weight. The issue with the GLP-1 medications is they are effective in terms of weight loss as well as other benefits which are being identified, but they may not get these patients with severe obesity to their lasting goal of a healthier weight," Dr. Heimbach says.

Bringing together experts from different medical specialties is essential when treating these patients, says Ty Diwan, M.D., Mayo Clinic transplant surgeon and the study's co-author.

"This study shows that caring for these complex patients extends beyond the transplant itself," Dr. Diwan says. "Multidisciplinary care is required to maximize patient outcomes, and that is what we see in this data. By bringing together experts in very different fields, we've improved patient care and overall health outcomes."

Additional resources:

• Mayo Clinic Minute: Dual procedure combines liver transplant, bariatric surgery

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Heather Carlson Kehren, Mayo Clinic Communications, newsbureau@mayo.edu

The post Study finds long-term health benefits from bariatric surgery and liver transplant appeared first on Mayo Clinic News Network.

This dual procedure is especially helpful for patients with metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease. MASLD happens when fat builds up in the liver, often without symptoms. It's mostly caused by obesity — defined as a body mass index (BMI) of 30 or higher. In advanced stages, MASLD can lead to serious liver damage that requires a transplant.

Watch: The Mayo Clinic Minute

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"Metabolic-associated steatotic liver disease is the most common liver disease, not only in the United States but worldwide," says Dr. Heimbach.

As obesity rates rise, so does the need to treat patients with MASLD.

"When we have excess fat that builds up in the liver, this can lead to inflammation and scarring and even advanced liver disease," she says.

It won't cause complications for everyone, but, for some, it can progress to cirrhosis.

"When a patient develops cirrhosis, they can then need a liver transplant," Dr. Heimbach says.

And having extra weight can be a reason patients might not be eligible for transplant. At Mayo Clinic, the approach is to help patients with obesity as well as transplant.

"We consider both liver transplant and what's called a sleeve gastrectomy, which is a type of weight-loss operation that can be used as a tool to help patients be successful in managing not only their liver disease with a liver transplant, but their obesity with the sleeve gastrectomy," Dr. Heimbach explains.

The procedures are done simultaneously with multiple teams working together. Dr. Heimbach says it's about providing patients the care they need.

"I'm excited about what transplant offers to all of our patients, which is to be able to return to the life that they had before they got sick. And for patients who were carrying extra weight, not only are they healthy again, but now they're able to really fully enjoy and be fully participating in their life," she says.

Additional Resources:

• Study finds long-term health benefits from bariatric surgery and liver transplant

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As a transplant surgeon, Timucin Taner, M.D., Ph.D., is a world-renowned physician and researcher. He has authored more than 100 peer-reviewed publications, performed pioneering surgeries and received numerous awards and honors. As an educator, Dr. Taner is training the next generation of transplant surgeons — just as he was trained when he began his residency in general surgery at Mayo Clinic School of Graduate Medical Education (MCSGME) 15 years ago.

In his role as division chair of transplantation surgery, Dr. Taner takes pride in Mayo's strong legacy of transplant surgery training. Mayo Clinic in Rochester has been training transplant fellows continuously since 1979, making it one of the oldest training programs in the United States.

A fellow is a graduate of medical school who has already finished their residency. Doctors pursue a fellowship to gain expertise in a specialized area of medicine, such as transplant surgery. During a fellowship, a doctor follows a specialist closely to get even more education in a single field of medicine.

"We really are preparing our fellows to become leaders in the field,” says Dr. Taner, "and every year, the interest and applications from our residency programs increases."

Mayo Clinic's abdominal transplant surgery fellowship, which Dr. Taner completed himself, offers a multidisciplinary approach that makes for well-rounded training, with fellows getting to work with hepatologists, nephrologists and endocrinologists. This is a strength of the program, according to Dr. Taner, as it ensures that fellows can take care of a patient not only in the operating room but also in the pre- and post-operative periods. Additionally, fellows must do a certain number of kidney, liver and pancreas transplants to be certified as an abdominal transplant surgeon.

An educational journey

After completing a medical degree, Dr. Taner earned his Ph.D. in transplant immunology. While in his doctoral program, he decided to become a transplant surgeon, beginning with a General Surgery residency with MCSGME in Rochester. After residency, he stayed at Mayo to complete the fellowship in abdominal transplant surgery. Dr. Taner looked at 10 other fellowship programs but ultimately decided there was no better program than Mayo's.

“I was truly ready when I took my first call on staff about a month after I finished my fellowship,” he says. “I still think it was one of the best training programs back then, as it is now.”

Part of what helps prepare fellows for the rigors of transplant surgery is the program's team-based approach. Nurse practitioners and physician assistants are incorporated into patient care, allowing the fellows to focus more on the surgical aspects of their training. Since Dr. Taner's time as a fellow, there is now a greater emphasis placed on the use of robotics in surgery. But what hasn't changed, he says, is the tremendous investment Mayo makes in training its surgical fellows.

The next generation of transplant surgeons

Omar Haque, M.D., M.P.H., understands that investment. Dr. Haque is a fellow in the Abdominal Transplant and Hepatopancreatobiliary (HPB) Surgery Fellowship in Rochester. He graduated from Mayo Clinic Alix School of Medicine and, after completing his surgical residency in Boston, was eager to come back home to Mayo Clinic for his fellowship.

"This was my top choice for fellowship. There is a long line of outstanding surgeons who trained here," says Dr. Haque. "I knew and trusted the Mayo environment, and it still felt like I was a part of the family here. Plus, if Dr. Taner was chosen to lead this institute, then it must be in good hands."

Very few institutions offer a dual fellowship in abdominal transplant and HPB surgery in two years, says Dr. Haque, who appreciates the versatility that this training offers him. The program is dual accredited by the American Society of Transplant Surgeons (ASTS) and the Americas Hepato-Pancreato-Biliary Association (AHPBA), which structures the training to include four rotations: donor procurements, kidney transplant, liver transplant and HPB surgery.

Since his fellowship began, Dr. Haque says he has received outstanding technical training and has been pleasantly surprised with how much operative autonomy Mayo Clinic gives its fellows. Eight months into a two-year fellowship, Dr. Haque feels independent in the majority of transplant operations, which is something he says is rare among other transplant fellowships.

In addition to being drawn to the world-class surgical training and the values of Mayo Clinic, Dr. Haque admits there was another factor in making his fellowship decision.

"Dr. Taner is one of the major reasons I came here. Not only is he one of the most technically talented surgeons I've ever come across, but also one of the most humble and kind," says Dr. Haque. "He is always there to support his fellows and treats everyone fairly, and that's really special coming from your chair."

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About Mayo Clinic School of Graduate Medical Education
MCSGME currently offers fellowships in three transplant surgical specialties, spanning all three Mayo campuses. Fellows perform hundreds of organ transplants annually and are active in transplant practice in the U.S. and abroad.

Mayo Clinic Graduate School of Medical Education is one of the nation’s oldest and largest institutions of graduate medical education and has more than 2,000 learners enrolled in programs across the country. Of those more than 300 programs, 197 are accredited by the Accreditation Council for Graduate Medical Education (ACGME), and 95 percent of Mayo’s GME training programs are above the national average in board passage rates.  

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When Tiffany Coco steps into a room at Mayo Clinic Transplant Center in Arizona, she focuses on the patient's needs beyond the medical updates.

"Often, patients put their best face forward with the physicians," says Coco, "And when they talk to us, they let their guard down and open up about how transplant affects their day-to-day life."

As a licensed clinical social worker embedded in multidisciplinary care teams, Coco uses her clinical expertise to assess patients' emotional, psychological and social needs to help them navigate their transplant experience.

Coco leads a team of 20 social work professionals who work alongside nursing and medical staff to deliver an unparalleled experience to patients and organ donors before, during and after their care at Mayo Clinic. Her commitment to this work is deeply personal.

From personal loss to professional calling

At age 15, Coco experienced a tragic loss when her mother passed away unexpectedly. Following this, her family faced a difficult decision: They chose to donate her mother's organs.

"I've been that family on the other side of the conversation," she says. "We woke up that morning not knowing our world would change forever that afternoon, that my mom was going to be gone and we would have to make that decision."

Coco had known from a young age that she wanted to pursue a career helping people; her experience as a donor family solidified her resolve and led her to social work. During graduate school, she began an internship at Mayo Clinic, which led to a full-time role. She joined the Transplant Center in 2013.

"Transplant is a second chance at life ― for the patient, their family and their community," Coco says. "No matter how many transplants I witness, it amazes me each time because I know there is another family that gets a chance that mine didn't."

Helping patients on 'a journey of cautious hope'

Across Mayo Clinic, more than 480 social workers in the Department of Nursing serve patients in all care settings. Social workers are licensed professionals whose work ranges from therapy and counseling to crisis intervention and connecting patients to resources to meet basic needs such as housing, child care and transportation.

In transplant care, social workers help patients and families navigate the emotional, financial and logistical challenges surrounding organ transplantation and left ventricular assist device (LVAD) therapy.

Coco calls the patients' experience "a journey of cautious hope" that begins well before the procedure day and sometimes ends without a transplant.

One of the most sensitive areas her team helps patients navigate is the experience of receiving an organ from a deceased donor.  

"To prepare for a transplant, you're preparing for a wave of emotions. It's the excitement. It's the nerves. It's worry. It's everything at once," Coco says. She helps them realize the donor's death would have happened regardless, and the decision to donate is a beautiful gift.

Coco and her team conduct comprehensive psychosocial assessments to identify factors that may affect care outcomes — such as a patient's occupation, housing situation, literacy skills and family dynamics — and bring their insights to the care team.

They serve patients during pre-transplant planning, the patient's hospital stay and post-transplant follow-up, sometimes providing lifelong support.

"We truly do walk along the journey, and we, as the social workers, are there making sure that they have a journey to walk on," says Coco.  

"If they don't have a house to go back to after their care, or if they have to choose between meds and meals, that's not quality of life." 

Holding patients' stories until they can carry them again

Coco says that from the time she first came to Mayo Clinic, she has been inspired by its culture of accountability and excellence. She admires the way healthcare professionals show deep respect for each patient as a person. This means remembering patients' stories and celebrating transplant anniversaries with them, sometimes 15 years or more after their procedures.

"A patient is not just their diagnosis. It's not just a heart patient ― it's Mr. John Doe, and his motivation for a transplant is to walk his daughter down the aisle. Or Miss Jane Doe, who wants to finish her degree and get married. These stories are the motivation that we hold for patients while they're going through it, and that we give back when they're ready to carry them again."

On her arm, Coco wears tattoos of the organs she's seen in her career. They're a visible reminder of the work she's devoted her life to and of how she is honoring her mother.

"Though I wish I still had my mom, her legacy lives on in not just those lives that were impacted through her organ donation but the patients I come in contact with and impact in a different way," she says.

"I went from being a little 15-year-old girl just trying to figure out her place in the world to being the supervisor who guides the helpers."  

Learn more

• Learn about social work at Mayo Clinic in Rochester and medical social worker careers.

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