ROCHESTER, Minn. — A Michigan man can blink, swallow, smile and breathe through his nose for the first time in a decade thanks to a face transplant performed at Mayo Clinic. This transformative and complex procedure underscores Mayo Clinic's skilled multidisciplinary surgical team who provide hope to patients with complex medical needs.

Derek Pfaff's life changed forever on March 5, 2014, when a tragic incident during his college years left his face severely damaged by a gunshot. 

"I was under a lot of pressure at college. I don't remember making the decision to take my own life. When I woke up in the hospital, I originally thought I had been in a car accident," he says. 

Despite undergoing 58 reconstructive facial surgeries in 10 years before going to Mayo Clinic in Rochester, he was still unable to eat solid food or speak casually with friends and family. Wearing glasses proved impossible without a nose. This transformational face transplant at Mayo Clinic means the now 30-year-old from Harbor Beach, Michigan, will once again be able to do all those things he has missed. He has also become a passionate advocate for suicide prevention and plans to share his story to encourage others who are struggling to get help.

"I lived for a reason. I want to help others," Pfaff says. "I am so grateful to my donor, his family and my care team at Mayo Clinic for giving me this second chance."

"Mayo Clinic Transplant Center is the largest integrated transplant center in the world. We were the first transplant center in the country to make face transplant part of its clinical practice. That has allowed us to focus exclusively on the needs of each individual patient," says Hatem Amer, M.D., medical director of Mayo Clinic's Reconstructive Transplant Program.

In the 19 years since the first face transplant was performed, more than 50 have been done around the world. Survival outcomes for these transplants are encouraging, according to a recent JAMA Surgery study. Mayo Clinic performed its first face transplant in 2016.

Derek's story: Just another face in the crowd

How the surgery was done 

Mayo Clinic surgeons performed Pfaff's face transplant in February 2024 in a procedure that lasted more than 50 hours and involved a medical team comprised of at least 80 healthcare professionals, including surgeons, anesthesiologists, nurses, technicians, assistants and other specialists. 

This multidisciplinary team was led by Samir Mardini, M.D., a facial reconstructive and facial reanimation surgeon and surgical director of Mayo Clinic's Reconstructive Transplant Program. Dr. Mardini estimates that 85% of Pfaff's face, including the mandible and maxilla, was reconstructed and replaced with donor tissue.  

Surgeons meticulously planned this complex operation over several months. To ensure precision and accuracy, a digital surgical plan was created relying on detailed scans of both the donor's and recipient's faces, allowing the team to perform the surgery digitally first. Facial nerve mapping also was performed of both the donor and recipient's nerve system to understand the function of each nerve. While the digital aspect ensured preparation, customized 3D-printed cutting guides translated these plans into tangible tools to be used in the surgical suite.

The intricate transplant required replacing virtually everything below Pfaff's eyebrows and part of his forehead, including his upper and lower eyelids and intraorbital fat, upper and lower jaws, teeth, nose, cheek structure, neck skin, hard palate and parts of his soft palate. Relying on the preoperative facial nerve mapping, one of the most critical aspects of the face transplant surgery was ensuring the donor and recipient's delicate facial nerves — 18 branches between the two sides — were properly connected to restore function. A new microsurgery technique also was employed to transplant the donor's tear drainage system, which allows Pfaff's tears to drain normally into his new nose. Pfaff can now express happiness, sadness, joy and disappointment through his transplanted facial muscles and nerves.

"Most organ transplants are lifesaving. With facial transplantation, it's a life-giving operation. You can live without it, but you are missing out on life," Dr. Mardini says.

The medical team included specialists from Plastic and Reconstructive Surgery, Transplant, Nephrology, Neurology, Ophthalmology, Dermatology, Pathology, Radiology, Critical Care, Anesthesia, Psychiatry, Infectious Diseases, Histocompatibility, Pharmacy, Nursing, Social Work, Rehabilitation, and Speech and Language Pathology.

"This successful transplant would not have been possible without the donor and his family's generous gift and the care team's collaboration and dedication," Dr. Mardini adds.

LifeSource, the federally designated organ procurement organization for the Upper Midwest, also played a pivotal role in the transplant, working closely with the family of the donor and Mayo Clinic care teams. Thanks to his face transplant, Pfaff says he is focused on making plans for his future.

"This surgery has transformed my life. I feel so much more confident. I am hoping to one day meet someone, settle down and have a family," he says. "I'm also going to keep sharing my story with others to help as many people as I can."

If you or someone you know is experiencing a mental health crisis, you can call the National Suicide Prevention Lifeline at 988. 

Journalists: Press kit, including b-roll, photos, interviews and animation available here. Derek Pfaff, his mother Lisa Pfaff and Dr. Samir Mardini are available for interviews. Please contact newsbureau@mayo.edu to schedule.

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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:

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

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ROCHESTER, Minn. — The Mayo Clinic Alumni Association is pleased to announce the 2024 recipients of the Mayo Clinic Distinguished Alumni Awards. The six recipients were honored at the Mayo Foundation House in October.

The Mayo Clinic Distinguished Alumni Award was established in 1981 by the Mayo Clinic Board of Trustees to acknowledge and show appreciation for the exceptional contributions of Mayo alumni to the field of medicine, including medical practice, research, education, and administration. Individuals receiving this award are recognized nationally — and often internationally — in their fields.

The 2024 recipients:

• Clifford Jack Jr., M.D. — Dr. Jack is a professor of radiology and the Alexander Family Professor of Alzheimer's Disease Research at Mayo Clinic College of Medicine and Science. He is a consultant in the Division of Neuroradiology at Mayo Clinic in Rochester. Dr. Jack is a preeminent leader in the area of imaging biomarkers and a field-shifting Alzheimer's disease pathophysiology researcher. His contributions laid the scientific groundwork for the development of disease-modifying, amyloid-lowering therapies for Alzheimer's.   
• Nita Maihle, Ph.D. — Dr. Maihle is a professor of medicine at the University of Mississippi Medical Center (UMMC) in Jackson, Mississippi. She is the former associate director for research at the UMMC Cancer Center and Research Institute. Dr. Maihle is a pioneer of translational cancer research and biomedical research training. Her work has improved cancer detection, prevention and treatment, particularly in cancers that affect women.
• Alexandre Nehme, M.D. — Dr. Nehme was instrumental in the creation of the Saint George University of Beirut medical school in Beirut, Lebanon. The school’s development was interrupted by a chemical explosion that destroyed over 80% of Saint George hospital. Dr. Nehme played a pivotal role in evacuation efforts. In the months that followed, he and colleagues proceeded with faculty and curriculum development for the medical school. Today, Dr. Nehme is the dean and a professor of clinical orthopedic surgery at the university.
• Rick Nishimura, M.D. — Dr. Nishimura is an emeritus professor of medicine at Mayo Clinic College of Medicine and Science in Rochester. Dr. Nishimura has received many awards for his work as an outstanding educator. He is also recognized worldwide as a master clinician with unparalleled experience in hemodynamics and the treatment of valvular disorders.
• Kerry Olsen, M.D. — Dr. Olsen is an emeritus professor of otolaryngology at Mayo Clinic College of Medicine and Science in Rochester. Dr. Olsen is a global expert in head and neck oncologic surgery. He has held many influential leadership and education roles, including serving on the Mayo Clinic Board of Governors, Board of Trustees and as elected president of Mayo Clinic staff in Rochester.
• Robert Wharen Jr., M.D. — Dr. Wharen is an emeritus professor of neurosurgery at Mayo Clinic College of Medicine and Science in Jacksonville, Florida. Dr. Wharen was the inaugural chair of the Department of Neurosurgery at Mayo Clinic in Jacksonville. Today, it’s considered a premier neurosurgery department with a world-class functional neurosurgery program, thanks in large part to Dr. Wharen’s leadership for more than 30 years as chair.

About the Mayo Clinic Alumni Association
The Mayo Clinic Alumni Association was incorporated in 1915 with a mission to connect our alumni and bring Mayo Clinic values to the world. The association serves more than 32,800 alumni who live and work in over 80 countries.

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:

• Lisa Speckhard-Pasque, Senior Communications Specialist, Alumni Relations, pasque.elisabeth@mayo.edu

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ROCHESTER, Minn. — A study at Mayo Clinic suggests that an hourglass-shaped stent could improve blood flow and ease severe and reoccurring chest pain in people with microvascular disease. Of 30 participants in a phase 2 clinical trial, 76% saw improvement in their day-to-day life. For example, some participants who reported not being able to walk around the block or up a flight of stairs without chest pain were able to do these ordinary physical activities at the end of a 120-day period. Clinical measures of blood flow related to the microvasculature of the heart significantly improved during follow-up, according to findings published in the Journal of the American College of Cardiology: Cardiovascular Interventions.

Microvascular disease is a condition in which tiny blood vessels in the heart are not working properly, resulting in reduced blood flow to the heart. The resulting chest pains, or angina, can be debilitating, limiting a person's ability to exercise, do household chores or even walk to the mailbox. About 40% of patients receiving a diagnostic coronary angiogram for chest pain do not have blocked arteries that also can cause angina. However, up to 66% of these patients do have coronary microvascular disease, which is more common in women overall and found in people with conditions such as diabetes, high blood pressure and obesity.

For decades, there have been few viable treatment options to improve blood flow through the tiny vessels of the heart. At most, doctors have treated symptoms of angina with several medications and cardiovascular disease prevention methods, including healthy eating, weight loss and regular exercise. The use of a stent could target the issue behind the chest pain — the severe reduction in blood flow affecting the heart muscle.

Unlike tube-shaped stents used to open clogged arteries, the hourglass-shaped stent narrows in the middle. The different design is thought to increase back pressure, redistributing blood flow more fully through small vessels in the heart that were not working at capacity.

"The patients with heart-related microvascular dysfunction in this study had little ability to control their chronic angina, which severely limited their day-to-day activities," says Amir Lerman, M.D., a cardiologist at Mayo Clinic and senior author of the study. "Beyond reductions in chest pain and being able to comfortably handle more physical activity, the majority of patients in the study also showed a connection between the changes in their coronary flow reserve, which is a measure of maximum blood flow, and changes in their quality-of-life responses on the survey. This points to the link between the physiological measurement and angina symptoms."

Dr. Lerman notes that more studies are needed to better understand how the reducer stent works and its long-term effects on blood flow. The stent did not improve chest pain symptoms in 20%-30% of the participants, so future research studies will need to better identify which patients respond best to this therapy.   

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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:

• Terri Malloy, Mayo Clinic Communications, newsbureau@mayo.edu

The post Hourglass-shaped stent could ease severe chest pain from microvascular disease appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Uterine fibroids are a common condition that affects up to 80% of women in their lifetime. Nearly half of those women will experience symptoms that affect their quality of life and fertility, including severe pain and anemia. Uterine fibroids are the major reason for the removal of the uterus by hysterectomy. However, Mayo Clinic researchers recommend minimally invasive treatment alternatives to hysterectomy, in an invited clinical practice paper published in the New England Journal of Medicine.

"Less invasive treatments can help women recover faster and resume their normal activities more quickly. Additionally, many studies have now shown that there are health benefits to keeping the uterus and the ovaries," says Shannon Laughlin-Tommaso, M.D., Mayo Clinic OB-GYN and co-lead author of the paper.

Removing the uterus, even while sparing the ovaries, increases the risks of cardiovascular disease, depression, anxiety and higher mortality. These risks are higher for people who get their uteruses removed at a young age.

"Women contemplating a hysterectomy deserve counseling about these risks since there are other less invasive options for many women with fibroids," Dr. Laughlin-Tommaso says.

A recent study found that nearly 60% of women undergoing hysterectomy for fibroids had not received a less invasive treatment first. Having alternative options to hysterectomy allow women to maintain their uteruses for longer.

These alternatives include medical therapies, hormone-releasing IUDs, radiofrequency ablation, focused ultrasound ablation and uterine artery embolization.

Early detection is key. When fibroids are found early, they tend to be smaller and less extensive. As a result, treating them early is medically less complicated.

The incidence of fibroids increases with age until menopause and is higher among Black women. In addition, this population often presents with more severe fibroids.

"Earlier diagnosis and treatment of uterine fibroids can help reduce this health disparity among Black women," says Ebbie Stewart, M.D., co-lead author and Mayo Clinic gynecologist and reproductive endocrinologist. In survey-based studies, many Black patients preferred minimally invasive therapies over hysterectomies.

Diagnosing fibroids is straightforward with a pelvic ultrasound but determining who to screen is not, and screening usually occurs after the fibroids are large or the patients are symptomatic. Many women with symptomatic fibroids have reported psychological suffering, including depression, concern, anger and body image distress. 

The researchers suggest that future studies should include screening younger women, particularly young Black women, and people with a strong family health history of fibroids to determine if early treatment reduces long-term risks.

Why a hysterectomy?

Hysterectomies have been the most common treatment for uterine fibroids for several reasons.

"Hysterectomy makes decision-making easier for medical providers and patients. For providers, they don't have to determine which fibroids to treat or remove. Hysterectomy is also universally available in OB-GYN practices," explains Dr. Laughlin-Tommaso.

Additionally, concerns about inadvertently missing a rare cancer that grows in the smooth muscle of the uterus, known as leiomyosarcoma, has led to an increased rate of hysterectomies over less invasive approaches.

Lastly, a major reason for hysterectomy is that fibroids can recur about 50% of the time within five years after they are removed. However, the researchers note that not all new fibroids will become symptomatic, especially among women entering menopause.

Review the paper for a complete list of authors, disclosures and funding.

Additional Resources:
NIH award supports new center at Mayo Clinic for health disparities in uterine fibroid treatment

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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:

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

The post Mayo Clinic researchers recommend alternatives to hysterectomy for uterine fibroids, according to study appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Doctors at Mayo Clinic used a new catheter-based approach to draw out resistant pockets of infection that settle in the heart, known as right-sided infective endocarditis, without surgery. Unless treated quickly, the walled-off infections can grow, severely damaging heart valves and potentially affecting other organs as well. In a recent study, over 90% of the participants had their infection cleared, and they had lower in-hospital mortality compared to those whose infections remained.

The research is part of a Mayo Clinic-led study across 19 U.S. sites involving patients who were not good candidates for surgery and whose right-sided heart infections had not responded to antibiotics. Abdallah El Sabbagh, M.D., an interventional cardiologist at Mayo Clinic in Jacksonville, Florida, was the study's principal investigator. Dr. El Sabbagh presented late-breaking research findings at the Transcatheter Cardiovascular Therapeutics Symposium on Oct. 30.

High-risk patients have few treatment options when a serious infection becomes entrenched in a heart valve. People with weakened immune systems, such as those who have had a transplant or cancer treatment, are more susceptible to such infections. IV drug users and patients with implanted medical devices such as pacemakers and artificial heart valves are also more likely to develop infective endocarditis. Approximately half of the 285 study participants were people who inject IV drugs.

"Our research findings show that using a catheter to draw out most of the heart infection potentially made a significant difference in a patient's response to antibiotic therapy afterward to clear up the infection. The participants in this study were all high-risk patients, and most were not responding to antibiotic therapy alone and were considered to have significant risks with open heart surgery. We were able to show that minimally invasive catheter-based aspiration of the infection is feasible, successful and may help a significant population of patients who otherwise have no alternative therapeutic options," says Dr. El Sabbagh.

The catheter-based system was originally developed to remove blood clots from the lungs without surgery. While its off-label use for infective endocarditis shows potential as a safe and effective option, Dr. El Sabbagh notes that further prospective study is needed.  

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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:

• Terri Malloy, Mayo Clinic Communications, newsbureau@mayo.edu

The post Research shows new method helps doctors safely remove dangerous heart infections without surgery appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Lifesaving cancer therapies can cause serious side effects, both immediately and later in life. "It is essential to continue to study innovative approaches that will eradicate the disease but won't diminish the quality of life for patients diagnosed with cancer," says Roberto Leon-Ferre, M.D., a breast medical oncologist at Mayo Clinic. With breast cancer rates rising among younger people, the need for treatments that provide excellent outcomes with fewer side effects is only increasing.

Mayo Clinic Comprehensive Cancer Center experts highlight breast cancer research that may reduce or eliminate the need for chemotherapy and endocrine treatments and may allow for shorter and less intense radiation therapy courses.

Prognostic Biomarker Identified in Triple-Negative Breast Cancer: Potential to Reduce Chemotherapy Use

Dr. Leon-Ferre's research team recently identified a prognostic biomarker in patients diagnosed with triple-negative breast cancer (TNBC), a type of breast cancer that does not have estrogen or progesterone receptors and that does not have excessive expression of HER2. The researchers found that patients with high levels of naturally existing immune cells called tumor-infiltrating lymphocytes (TILs) within their tumors may have a lower risk of cancer recurrence and better survival rates, even when chemotherapy is not administered.

"This is an important finding because triple-negative breast cancer is a particularly aggressive form of breast cancer that does not respond to hormonal therapies or drugs targeting the HER2 protein," says Dr. Leon-Ferre. "This means treatment options are more limited, often more intense and harsher for patients. However, some patients with TNBC can be cured without chemotherapy, and the key is identifying who those patients are ahead of time." He adds that future research will explore whether TILs can be used to decide who may need and may not need chemotherapy after a TNBC diagnosis.

Study Explores Necessity of Chemotherapy in Premenopausal Women with Intermediate-Risk Breast Cancer

In a separate ongoing trial, Tufia Haddad, M.D., breast medical oncologist at Mayo Clinic, is co-chair of a study comparing two treatment regimens in premenopausal women with intermediate-risk breast cancer: one group with chemotherapy plus ovarian suppression and hormone therapy, and another group without chemotherapy but with ovarian suppression and hormone therapy. The study aims to determine whether chemotherapy's benefits come from its ability to suppress ovarian function (thereby reducing estrogen production) or from its direct cancer-fighting effects. "The results could determine if chemotherapy is necessary or if ovarian suppression and hormone therapy alone are enough in this group of patients, sparing them from the side effects of chemotherapy," says Dr. Haddad.

Endoxifen: A Potent Therapy for Estrogen-Receptor-Positive Breast Cancer Explored by Mayo Clinic

Matthew Goetz, M.D., a breast medical oncologist and director of the Mayo Clinic Breast Cancer Specialized Programs of Research Excellence (SPORE), and the Erivan K. Haub Family Professor of Cancer Research Honoring Richard F. Emslander, M.D., has spent more than a decade studying the use of endoxifen for the treatment of patients with estrogen-receptor-positive breast cancer (ER-positive breast cancer or ER+), the most common subtype of breast cancer.

Endoxifen, the most potent byproduct of tamoxifen, stops the growth of estrogen-dependent cancer cells and blocks protein kinase C, which may contribute to the aggressiveness of some cancers. Premenopausal patients with ER+ breast cancer are treated with ovarian function suppression and aromatase inhibitors to lower estrogen levels and slow cancer growth. While effective, this regimen causes significant side effects from deep estrogen suppression. Dr. Goetz's SPORE-funded study explores whether endoxifen alone can eradicate cancer cells, potentially eliminating the need for more toxic treatments like chemotherapy. He is also studying the role of protein kinase C in ER+ breast cancer.

Mayo Clinic Study Finds Shortened and Less Intense Radiation Therapy Effective for Breast Cancer Patients

Radiation therapy can be an essential part of a person's breast cancer treatment plan; however, it can lead to changes in the appearance of the skin, swelling, pain and other complications. These side effects can be detrimental to a patient's quality of life. In a recent study, Mayo Clinic breast cancer researchers found they can safely reduce the intensity and shorten the course of radiation treatment to three days for select patients with breast cancer following their lumpectomy.

"Normally, this treatment takes five to 15 days and can sometimes cause unwanted side effects, including changes in how the breast looks. However, this new method administers a lower dose of radiation over just three sessions using either photons, protons or brachytherapy," says Robert Mutter, M.D., a Mayo Clinic radiation oncologist and lead author of the study. "The new personalized approach was well-tolerated by the patients and resulted in excellent cancer control with better long-term aesthetic results compared to what has previously been reported with longer treatments."

Collectively, this research is leading to innovative approaches and helping clinicians and patients make informed treatment decisions, potentially sparing patients from some of the more severe side effects of chemotherapy, endocrine therapy and radiation.

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About Mayo Clinic Comprehensive Cancer Center 
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact:

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

The post Mayo Clinic experts highlight advances in breast cancer research: Decreasing the need for chemotherapy and reducing the intensity of radiation therapy appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — How long a person can stand — on one leg — is a more telltale measure of aging than changes in strength or gait, according to new Mayo Clinic research. The study appears today in the journal PLOS ONE.

Good balance, muscle strength and an efficient gait contribute to people's independence and well-being as they age. How these factors change, and at what rate, can help clinicians develop programs to ensure healthy aging. Individually, people can train their balance without special equipment and work on maintaining it over time.

In this study, 40 healthy, independent people over 50 underwent walking, balance, grip strength and knee strength tests. Half of the participants were under 65; the other half were 65 and older.

In the balance tests, participants stood on force plates in different situations: on both feet with eyes open, on both feet with eyes closed, on the non-dominant leg with eyes open, and on the dominant leg with eyes open. In the one-legged tests, participants could hold the leg they weren't standing on where they wanted. The tests were 30 seconds each.

Standing on one leg — specifically the nondominant leg — showed the highest rate of decline with age.

"Balance is an important measure because, in addition to muscle strength, it requires input from vision, the vestibular system and the somatosensory systems," says Kenton Kaufman, Ph.D., senior author of the study and director of the Motion Analysis Laboratory at Mayo Clinic. "Changes in balance are noteworthy. If you have poor balance, you're at risk of falling, whether or not you're moving. Falls are a severe health risk with serious consequences."

Unintentional falls are the leading cause of injuries among adults who are 65 and older. Most falls among older adults result from a loss of balance.

In the other tests:

• Researchers used a custom-made device to measure participants' grip. For the knee strength test, participants were in a seated position and instructed to extend their knee as forcefully as possible. Both the grip and knee strength tests were on the dominant side. Grip and knee strength showed significant declines by decade but not as much as balance. Grip strength decreased at a faster rate than knee strength, making it better at predicting aging than other strength measures.
• For the gait test, participants walked back and forth on an 8-meter, level walkway at their own pace and speed. Gait parameters didn't change with age. This was not a surprising result since participants were walking at their normal pace, not their maximum pace, Dr. Kaufman says.
• There were no age-related declines in the strength tests that were specific to sex. This indicates that participants' grip and knee strength declined at a similar rate. Researchers did not identify sex differences in the gait and balance tests, which suggests that male and female subjects were equally affected by age.

Dr. Kaufman says people can take steps to train their balance. For example, by standing on one leg, you can train yourself to coordinate your muscle and vestibular responses to maintain correct balance. If you can stand on one leg for 30 seconds, you are doing well, he says.

"If you don't use it, you lose it. If you use it, you maintain it," Dr. Kaufman says. "It's easy to do. It doesn't require special equipment, and you can do it every day."

Funding for this study includes the Robert and Arlene Kogod Professorship in Geriatric Medicine and W. Hall Wendel Jr. Musculoskeletal Professorship.

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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:

• Rhoda Madson, Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic study: What standing on one leg can tell you appeared first on Mayo Clinic News Network.

Liver swap gives two patients a second chance at life

ROCHESTER, Minn. — Surgeons recently performed Mayo Clinic's first paired living liver donation, a significant first step in helping more people with liver failure get a lifesaving transplant.

"Liver transplantation is the only treatment option for most people with end-stage liver disease. But sadly, there are not enough donated livers available for everyone who needs one. That is why living liver donation is so important," says Timucin Taner, M.D., Ph.D., division chair of Transplant Surgery at Mayo Clinic who led the team that completed the clinic's first paired liver donation.

At any given time, there are approximately 10,000 people on the waiting list for a liver transplant in the U.S. Approximately 20% of people on the list will die waiting for a transplant. Living liver transplant offers another option, but only 6% of liver transplants performed last year came from living donors, according to the Organ Procurement and Transplantation Network.

How paired liver donation works

People can donate up to 70% of their liver because the liver has the unique ability to regenerate itself within a month. While paired living donation is commonly used for kidney transplants, it is relatively rare for liver transplants. Sometimes a potential donor who wants to give to a family member or friend isn't the best match for that recipient. In those situations, paired donation is considered. Donors and recipients are matched with other donors and recipients, creating a so-called "liver chain." In the case of Mayo Clinic's first paired liver donation, altruistic donor Michael Broeker, M.D., agreed to give a portion of his liver to a stranger, helping to kick-start the swap. He had previously donated a kidney and wanted to do more.

"I knew I wanted to be a living liver donor to help someone else. I was excited to have the opportunity to be a part of Mayo Clinic's first paired liver donation," says Dr. Broeker, of Eagan, Minnesota.

The paired liver donation surgeries were performed in August, and both donors and recipients are doing well. Only a handful of transplant centers in the U.S. offer paired liver donation because it is a major logistical undertaking. It requires a large healthcare team of nurse coordinators, physicians, social workers and others who can match patients. It also requires surgical teams to carefully coordinate.

Dr. Taner says he expects Mayo Clinic will do more paired liver donations in the future to help more patients get the transplants that they need. He encourages people who are healthy and between the ages of 18 to 60 to consider becoming a living liver donor.

"The biggest misconception about living donation is sometimes people think that they won't be able to have a normal life after the donation, which is wrong," Dr. Taner says. "It is a big operation, and it is important for patients to understand that. But once it is over, the liver regenerates to its full size, and the vast majority of people don't have long-term consequences after donation."

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Related Content:

• Liver’s regenerative ability allows for living donors

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 Mayo Clinic performs its first paired living liver donation appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Dispose of unneeded medications safely during National Prescription Drug Take Back Day on Saturday, Oct. 26.

Mayo Clinic, in collaboration with the Olmsted County Sheriff's Office, Olmsted Medical Center, Zumbro Valley Medical Society and the federal Drug Enforcement Administration (DEA), will host a community drop-off event to collect unused or expired medications. New this year, the Rochester Fire Department, Olmsted County Drug & Alcohol Response Team, Mayo Clinic Ambulance Service and Rochester Police Department will be onsite with optional interactive opportunities to learn more about community drug safety and emergency response.  

"The Olmsted County Sheriff's Office looks forward to working with our community partners to offer a safe way to dispose of any unneeded medications and to provide education and assistance to community members looking for information regarding drug safety including how to use naloxone," says Capt. Tim Parkin of the Olmsted County Sheriff's Office.

Anyone can anonymously drop off medications in Rochester on Oct. 26 from 10 a.m. to 2 p.m. at Mayo Family Clinic Northeast, 3041 Stonehedge Drive NE. This is a change from previous events held at Mayo Clinic's Gonda Building in downtown Rochester.

"National Prescription Drug Take Back Day events are a great way to take back and dispose of unused and expired prescription and over-the-counter medications," says Benjamin Lai, M.B., B.Ch., B.A.O., a family medicine physician and chair of Mayo Clinic's Opioid Stewardship Program.

Dr. Lai adds that the new location provides a quick and convenient place for people to drive through and drop off their excess medications, as well as a family educational experience for those who park to visit with public health and safety representatives. "Ask the DART team about naloxone. In my book, it's a must for most families' first aid kits," he says.

Medications accepted for safe disposal at take-back locations include:

• Prescription drugs
• Over-the-counter medications
• Ointments, patches, creams, inhalers and vials
• Pet medications
• Nonaerosol medications

Liquid medications must be in the original container. Vape pens and other e-cigarette devices are accepted with the batteries removed. 

"Unused medications stored in the home can increase the risk of accidental ingestion by children and pets," says Dr. Lai. "It could also lead to medications, especially opioids, landing in the wrong hands, further fueling the already devastating opioid crisis in our country."

For those who live outside of Rochester, visit the DEA National Prescription Drug Take Back Day website to find a drop off location in your area.

Community members who cannot attend the National Prescription Drug Take Back Day event can dispose of medications safely in the prescription drug collection box at the Olmsted County Government Center. The box is in the vestibule of the Adult Detention Center and is accessible around the clock every day of the year. Several pharmacies in the community also offer collection boxes — locate your nearest box with the DEA's year-round disposal site locator tool.

Alert to journalists: Journalists interested in covering the event are invited to arrive between 10 and 11 a.m. Representatives from participating agencies will be available for onsite interviews.

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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:

• Vincent Jacobbi, Mayo Clinic Communications, newsbureau@mayo.edu

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October is Breast Cancer Awareness Month  

JACKSONVILLE, Florida — There are two surgical options to treat breast cancer: lumpectomy and mastectomy. But there are many more reasons why women choose one over another, says Sarah McLaughlin, M.D., a breast surgical oncologist and chair of the Department of Surgery at Mayo Clinic in Jacksonville, Florida.

"Some of that can be cancer-based, some of it can be family history and genetic, some of it can be personal peace of mind," Dr. McLaughlin explains.

More than 2 million women are diagnosed with breast cancer every year, according to the World Health Organization. Advances in treatment including surgical innovations are helping women and their healthcare teams personalize care and improve quality of life.

Breast cancer treatment involves a surgery to remove the cancer from the breast. It’s often used with other treatments, such as radiation therapy, chemotherapy, hormone therapy and targeted therapy. Surgery may also be used to reduce the risk of future cancer.

Surgical options include:

• Lumpectomy: Removing cancerous tissue and the surrounding margin of normal breast tissue.
• Mastectomy: Removing the entire breast.
• Sentinel lymph node biopsy: Removing a few lymph nodes to check whether cancer has spread to them.
• Axillary lymph node dissection: removing more lymph nodes from under the arm if there is many sentinel lymph nodes with cancer in them.  
• Reconstructive surgery: Breast reconstruction following a mastectomy rebuilds the breast.

The approaches to all of these options are evolving as knowledge grows. For example, decades of research have shown similar long-term survival rates for lumpectomies and mastectomies, Dr. McLaughlin explains.

"If you don't need a mastectomy, you wouldn’t do better or live longer because you have one,”  Dr. McLaughlin says.

Some patients no longer need lymph nodes under the armpit removed. 

Contemporary mastectomy techniques focus on removing less skin and preserving the nipple and areola when possible. 

In oncoplastic surgery for lumpectomies, surgeons place incisions remote from the actual site of cancer and, after removing cancerous tissue, rearrange the breast tissue that remains to maintain a cosmetically acceptable breast, Dr. McLaughlin says.

Dr. McLaughlin’s research focuses on improving the quality of life for breast cancer survivors. She is contributing to the establishment of a breast organoid biobank at Mayo Clinic using excess breast tissue from volunteers to speed research.

“Breast cancer patients are living longer and longer and longer, so issues of survivorship are becoming much more important,” Dr. McLaughlin says.

One significant issue for breast cancer survivors who have had lymph nodes removed can be lymphedema, tissue swelling caused by an accumulation of fluid that usually is removed by lymph nodes. Lymphedema can cause symptoms ranging from mild to severe, including discomfort, swelling, a feeling of tightness or heaviness, limited range of motion, recurring infections and hardened skin.

Dr. McLaughlin’s work includes studies to predict, prevent and improve treatment of lymphedema, including identifying biomarkers and developing tailored treatment strategies.

“There’s a lot of current focus on techniques to reduce the risk of developing lymphedema,” she explains.

Those techniques include axillary reverse mapping, which maps the lymph nodes that drain the arm, separating them from those that drain the breast, allowing the surgeon to remove only those that drain the breast. Another option is reconstructing the lymphatic system if there is extensive lymph node removal.

Lymphedema can be debilitating and a chronic reminder of the cancer treatment,  Dr. McLaughlin says.

“The intense focus on management and therapy related to it becomes time-consuming, expensive and painful for patients to manage,” she adds. “We want to try to reduce that as much as possible.”

It's important to work with your healthcare team to determine what treatments are best for you. Considerations may include the stage of cancer, your personal preferences and overall health.

“Our goal is to do as little as possible while achieving the highest level of success, which is long- term survival,” Dr. McLaughlin says.

For more information about breast cancer, visit the Mayo Clinic Comprehensive Cancer Center blog.

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About Mayo Clinic  
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Media contact:  

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

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