CLEVELAND — A 33-year-old Minnesota man is back doing many of the things he loves, including biking and walking, just nine months after a full multi-organ transplant was performed on him at Cleveland Clinic to treat a rare cancer.
In 2019, Andy Voge was diagnosed with with a rare form of appendix cancer called pseudomyxoma peritonei (PMP). PMP originates as a tumor in the appendix, then ruptures, causing its jelly-like content to spread to other digestive organs. Andy had surgery performed at the Mayo Clinic and seemed to be making great progress in his recovery. But by 2020, Andy's tumor returned and his health began to decline rapidly.
At the end of January 2021, Voge was hospitalized again due to a hole in his bowel. “They wanted to go in and operate, but they just couldn’t get to the bowel,” he told NBC's Kate Snow on the TODAY Show. “That’s when my doctor told me I had about a 50-50 shot of making it through that night."
Andy did make it through the night, but was not expected to have much longer to live. Maybe six months.
Meanwhile, Cleveland Clinic welcomed a new specialist in 2020. Dr. Anil Vaidya became the co-director of the Clinic's Intestinal Transplant Program. In England, he had performed the world’s first modified multi-organ transplant (excluding the liver) to treat a patient with PMP who had exhausted all other management strategies.
Now in Cleveland in 2021, Dr. Vaidya had happened to speak to Andy Voge's doctor at the Mayo Clinic about his case.
“The patient had one of the more advanced cases of PMP I have seen,” said Dr. Vaidya in a Cleveland Clinic release. “While about 80% of patients with the condition can be treated with traditional therapies, what do you do with the 20% for whom the traditional therapy isn’t successful? In some cases, the answer may be a multi-organ transplant.”
At the time of his referral to Cleveland Clinic, Andy was in the end stage of his disease. He was no longer working and was receiving hospice care. Andy could no longer eat solid foods and was receiving nutrients intravenously.
Dr. Vaidya received approval from Cleveland Clinic’s Intestinal Transplant Selection Committee to proceed with a multi-organ transplant for Andy, who was placed on the national transplant waiting list in July 2021.
“The patient – who needed a liver and four other digestive organs – had started to deteriorate quite rapidly,” said Dr. Vaidya. “It was touch-and-go that he would make it.”
A donor was found and the groundbreaking surgery took place at Cleveland Clinic in September of 2021. During the 17-hour operation, surgeons led by Dr. Vaidya removed Andy's diseased organs. He then received the donor’s organs all together and at the same time: liver, stomach, pancreas and duodenum (pancreaticoduodenal complex), spleen, small intestine, and right colon.
“The operation was well planned and went like clockwork,” said Dr. Vaidya. “The team members knew exactly what they were going to do, and the timing was perfect. It went really well. As far as we know, it is the first time in the world that a full multi-organ transplant, including the liver and four other digestive organs, is performed to treat PMP."
Now Andy is back on his bike, telling TODAY that he went on a 30-mile ride recently. But he also understands his journey is not over.
“The unfortunate part with appendix cancer is it does have a really high recurrence rate, so the future is still pretty uncertain. But it’s definitely a lot better than it was,” Voge told Snow, adding “Dr. Vaidya is very hopeful about the long term outcome."
According to Vaidya, the chances that he will still have these organs in 10 years are about 70%.
“There is currently no evidence of cancer recurrence,” Dr. Vaidya added.
Watch animation of a multivisceral organ transplant, courtesy of Cleveland Clinic, below:
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