After more than 22 months at Mayo Clinic Children's, 13-year-old Ava Weitl went home to Iowa. She and her family were met with tears and cheers as dozens of members from her care team, who are now considered friends of the family, said goodbye and wished her well. 

This was a day Ava had been looking forward to after a long journey with heart failure, two lifesaving extracorporeal membrane oxygenation (ECMO) therapies, a heart transplant, kidney failure and a kidney transplant. 

Watch: 13-year old Ava Weitl leaves Mayo Clinic Children's after a 22-month hospital stay

Journalists: Broadcast-quality natsound video is in the downloads at the end of the post. Please courtesy: "Mayo Clinic."

Born with hypoplastic left heart syndrome (HLHS), a life-threatening condition where the left side of the heart is severely underdeveloped, Ava faced three open-heart surgeries before she would reach her 5th birthday. Within 90 minutes of her birth, her first surgery was performed. Her second surgery was completed months later, but the third, typically required for HLHS patients between the ages of 3 and 4, was not possible due to other medical concerns. 

For a handful of years, Ava's care team monitored her to see what her body would do. During that time, Ava felt good and was "defying the odds," as her mom, Christina DeShaw, would say. 

It was in 2021, during third grade, when Ava began to show signs of her heart and lungs struggling. While cardiac catheterization improved the blood flow to her lungs, it was a temporary improvement, and by early 2023, doctors determined a heart transplant was her only option.

Officially listed for a heart transplant in February 2023, Ava's condition worsened, leading to hospitalization at Mayo Clinic in September 2023. That hospital stay was the start of her long journey of constant monitoring and tests, and it wasn’t easy on her family as they navigated life split between Minnesota and Iowa. 

In December 2023, Ava's condition took a critical turn. Ava was placed on life-sustaining ECMO, which provides heart and lung support when those organs are failing. Then, Feb. 26, 2024, the call came: a donor heart became available. The surgery was successful, but postoperative challenges arose.

Weeks later, complications with her lungs led to a return to ECMO for three months. She also needed a tracheostomy placed. While trying to save her lungs, her kidney function began to fail, leading to another gift of life — a kidney transplant on Jan. 25, 2025, thanks to a donation from her uncle through a kidney exchange with the National Kidney Registry. 

"She's a walking miracle," her mother says. "We can't even wrap our heads around what she's been through."

Ava is excited to be home with her parents, Christina and Brad, her twin brother, Aiden, and her younger brother, Miles. She says she looks forward to hanging out with friends, going back to school and having a barbecue with her family. 

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ROCHESTER, Minn. — While immunosuppressive medications are critical to prevent rejection of transplant organs, they also come with plenty of downsides. They can cause harsh side effects, like headaches and tremors, and increase the risk for infection and cancer. But what if there was a way to prevent organ rejection without using these medications?

That goal fuels the work of Mark Stegall, M.D., a longtime Mayo Clinic transplant researcher. He leads a team of researchers developing pioneering therapies to prevent organ rejection without the need for immunosuppression. A recently published study in the American Journal of Transplantation is offering hope for patients.

Using stem cells to prevent organ rejection

Mayo Clinic participated in the multisite phase 3 clinical trial detailed in the study. The goal was to see whether people who simultaneously received both a kidney and stem cell transplant from a closely matched sibling could discontinue all immunosuppressive medications after a year. The results were promising. The study found that 75% of participants were able to stop taking the medication for more than two years. At Mayo Clinic, three patients participated, with two off immunosuppression medications for over three years and one on a low dose.

"I've been involved in transplant research for more than 30 years, and we've done quite a few amazing things. But in the scheme of things, this research is right at the very top. It's been a goal — to be able to safely get transplant recipients off immunosuppression — for longer than I've been doing this. We're very excited about it," says Dr. Stegall, a co-author of the study.

The research being done across Mayo Clinic is part of a growing trend in transplant to explore ways to use cellular therapies to prevent organ rejection. It is also a cornerstone of Mayo Clinic's Transforming Transplant Initiative, which has the bold goal of ensuring everyone who wants a transplant can get one and to make transplants more successful.

To qualify for the clinical trial, the transplant recipients and donors needed to be siblings whose tissue types closely matched. The donor agreed to donate their stem cells in addition to their kidney to their sibling. The recipient receives the transplant, undergoes radiation and then receives the stem cell transplant. The goal was to wean recipients off immunosuppression medication after a year.

'Almost like the transplant didn't happen'

For Minnesota native Mark Welter, the results have been better than he imagined. Four years ago, he needed a kidney transplant due to polycystic kidney disease, an inherited condition that causes cysts to grow on the kidneys. The Mayo Clinic patient volunteered to be a part of the clinical trial in hopes of not having to worry about immunosuppression medication the rest of his life. His younger sister Cindy Kendall immediately stepped forward to donate a kidney and her stem cells to help her brother.

"Being able to see him get off those medications has been amazing," Cindy says. "He just gets to live his life to the fullest. He has been able to see both of his daughters get married and meet his grandchildren."

Watch: Inteview with Mark Welter, Cindy Kendall and Dr. Mark Stegall

Mark has not taken immunosuppression medication for more than three years.

"I feel fantastic. I actually feel like I did before the transplant, which has been the greatest thing," Mark says. "It's almost like the transplant didn't happen."

There is still plenty of work to be done to advance this research. This clinical trial only involved siblings with closely matching tissue types. Researchers want to know if stem cell transplants can prevent rejection in recipients paired with a less closely matched donor.

"Even in closely matched siblings, immunosuppression is needed lifelong. We have seen stopping medications even at eight to 10 years post-transplant leads to rejection. Our goal is to find ways to reduce or stop immunosuppressive medications after transplant so patients can have longer lasting kidneys with fewer side effects," says Andrew Bentall, M.B., Ch.B., M.D., a Mayo Clinic transplant nephrologist.

Journalists: Press kit, including b-roll, photos and interviews are available here. Clinical trial participants and Mayo researchers are available for interviews. Please contact newsbureau@mayo.edu to schedule.

###

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:

• Kelley Luckstein, Mayo Clinic Communications, newsbureau@mayo.edu

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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 Scherer. 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

Journalists: Broadcast-quality video (2:43) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

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

Journalists: Broadcast-quality video pkg (2:21) is in the downloads at the end of the post. Please courtesy: "Mayo Clinic News Network." Read the script.

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.

The post A Mayo first: Innovative transplant procedure saves patient’s life after heart failure appeared first on Mayo Clinic News Network.

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. 

The post Mayo Clinic in Arizona announces launch of new lung transplant program offering hope and restored function to patients facing advanced lung disease appeared first on Mayo Clinic News Network.

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. 

### 

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 

The post Mayo Clinic discovery could mean better access to more donor hearts and improved transplant outcomes appeared first on Mayo Clinic News Network.

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

The post A special graduation: Mayo Clinic care team organizes graduation walk for patient appeared first on Mayo Clinic News Network.

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

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• 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

The post Mayo Clinic Minute: Dual procedure combines liver transplant, bariatric surgery appeared first on Mayo Clinic News Network.