Chicago man receives heart-liver transplant

Third time in Illinois for rare transplant combination

March 3, 1998

On Monday, March 2, 1998, 45-year-old Stephen Trenka of Chicago received a very welcome surprise: a new heart and liver. The procedure has been performed only 10 times in the United States, including three times at the University of Chicago Hospitals. Both previous UCH patients are alive, at home and doing well.

The heart/liver transplant, which went smoothly, began at about 8 a.m. The cardiac team, led by Mario Albertucci, MD, assistant professor of surgery at the University of Chicago, performed the heart transplant first. At 1 p.m., a second surgical team, led by Kenneth Newell, MD, assistant professor of surgery, and Michael Millis, MD, associate professor of surgery and director of the liver transplant program, began the liver operation, which lasted until 7 p.m.

The next morning, Trenka was listed as in critical but stable condition, which is customary after a transplant. The transplanted organs all appeared to be working normally and by noon he was able to breathe without the aid of mechanical ventilation.

"Any heart that can withstand the rigors of an immediate liver transplant is doing pretty well," suggested Dr. Albertucci.

Trenka still must clear several hurdles, however. In the first few days after a transplant physicians are most concerned that the new organs continue to function normally and receive adequate flow through the newly connected blood vessels that supply them. A week after the operation, the first signs of rejection can appear as the recipient's immune system recognizes the transplanted organs as foreign tissue. The drugs that patients receive to suppress this immune response leave the patient more susceptible to infections.

The surprise in this case was the speed with which the organs became available. Trenka's health had declined rapidly because of his combination of advanced heart and end-stage liver disease. He was placed on the waiting list for a heart last Thursday and for a liver last Friday. Because of his urgent need, his unusual blood type and a good deal of luck, the two organs, from a single donor, were found for him early Monday morning. (A kidney/pancreas transplant from the same donor also was performed by a different University of Chicago surgical team on Monday.)

No information about the donor is available.

Trenka recently completed a masters degree in psychology and married his high-school sweetheart. Before returning to school, he had worked as a loan officer in a bank, but after 20 years in that field he decided to go back to school and start a second career counseling young adults.

He will counsel them not to drink. Trenka's liver and heart disease resulted, in part, from alcohol intake. He initially came to the hospital for symptoms of liver disease but during his evaluation for a liver transplant, extensive heart damage was detected. As a result, he was placed on both lists.

But because drinking alcohol can cause liver and heart damage, Trenka had to undergo extensive psychological evaluation and demonstrate complete abstinence from alcohol for more than six months before being placed on either transplant list. He has not ingested alcohol since last April.

High-risk ventures and complicated surgeries are not entirely new for Trenka. Twelve years ago, while on vacation in Cancun, his rented motor boat was hijacked. As the thieves escaped, they ran over his left hand and leg with the boat's propeller, leaving him to drown. Despite these injuries, Trenka--a three-sport athlete in high school--swam one-half mile to shore using only his right arm and leg.