Transplant Patient Gets Fresh Start | by Andrea Juarez | photos Dan Sidor

P/SL Transplant Center

Posted on Thu, Oct 11, 2018

P/SL Transplant Center Is Top Notch 

Turning 50 years old can be meaningful to people for many reasons: for some it is a time to be reflective and for others to look forward. For Sal Sandoval, an Aurora resident and recent kidney transplant patient, it’s a bit of both.

P/SL Transplant Center

Aurora resident Sal Sandoval underwent a kidney transplant in April 2018 after years of struggling with a rare kidney disease; his new kidney was donated by his wife Nancy.

“This year’s been like a rebirth, like I’ve gotten a new life and get to start fresh again,” says Sal, who turned 50 in April.

In 2010, Sal’s life and health took an unexpected turn after attending a health fair screening. He learned he had high blood pressure and was immediately referred to a doctor who, after many tests, determined that he had focal segmental glomerulosclerosis, or FSGS, a rare disease that causes serious kidney damage.

Three years later Sal was diagnosed with stage 2 kidney damage and by 2017 he was at stage 4. By the spring of 2018, his doctors at Presbyterian/St. Luke’s Medical Center (P/SL) recommended he undergo a transplant soon, rather than wait until he had to go on dialysis.

With a kidney donated by his wife Nancy, Sal had a transplant at P/SL’s Kidney Transplant Center in April 2018.

P/SL Living Donor Champion Program

“Before his transplant, I saw his health declining: I saw him struggle to put on his boots, to be tired and cold, to see his frustration with his foggy mind,” says Nancy. “It was a huge weight off my shoulders when I was told I could be his donor.”

Most patients in need of a transplant don’t walk in with a living donor like Sal did, says Dr. Vidya Bhandaram, Kidney Transplant Medical Director at P/SL.

Dr. Vidya Bhandaram, P/SL transplant center

Dr. Vidya Bhandaram

“It can be an awkward situation to ask a loved one or anyone for an organ,” Bhandaram says. So, P/SL created the Living Donor Champion Program to help.

How does it work? Patients identify a friend or family member to be a champion and that champion will learn about organ donation from living donors, as well as ways to spread the word and to make “the ask.” This unique program at P/SL is run by a physician and social worker who provide the medical and resource knowledge to support the patient and champion through the transplant process, including finding a donor and even fundraising.

“Had my wife not been a match, we would have been involved with the Living Donor Champion Program,” says Sal. “We appreciated having a plan in place in case it didn’t work with my wife. The program is top notch.”

Notably, organ donation from living donors (rather than deceased donors) is preferred. “Donations from live donors have improved results,” says Bhandaram. “Generally, they last twice as long, and have much less risk of complications.”

Rare Surgical Technique for Kidney Donors

Many kidney donors and recipients, such as Nancy and Sal, are concerned about the well-being of donors who generously agree to give their kidneys. Fortunately, Dr. Marklyn Jones, Living Donor Surgeon at P/SL, specializes in robotic donor nephrectomies, a minimally invasive procedure in which the kidney is removed using a state-of-the-art robotic surgical system.

Dr. Marklyn Jones, P/SL Transplant Center

Dr. Marklyn Jones

“The instruments we use allow for complex and intricate dissections,” Jones says. With this surgery, donors experience decreased blood loss, reduced risk of a blood transfusion, a shorter hospital stay, decreased pain and recovery time, and are able to return to work sooner. Nancy went back to work just two and a half weeks after donating her kidney to her husband.

Jones says P/SL is the only program in the Rocky Mountain region and one of the few in the nation performing robotic donor nephrectomies.

Steroid-Free Protocols

After his transplant, Sal took part in P/SL’s Steroid-Free Protocols (SFP), an after-transplant treatment plan with minimal risk to eligible candidates that minimizes patients’ reliance on prednisone, an immunosuppressant drug used to prevent the body from rejecting an organ transplant.

With SFP, Sal was on steroids for just three days after surgery, whereas most transplant patients take prednisone for the rest of their lives, explains Bhandaram. She says they frequently suffer long-term side effects such as weight gain, new onset diabetes, osteoporosis, skin changes, gastritis and hypertension fluid retention, as well as emotional disturbances.

“SFP is an important choice we give our patients,” Bhandaram says. “There are only a few places in the country that do this.” 

Looking Forward

“We wake up every day and move forward,” says Nancy. “I know he is going to be in my life and I’m so grateful to help save the person who means the most to me in the world.”

Five months after Sal’s kidney transplant, he says all is well for him and Nancy. They are planning their future and getting settled into a new home.

“After my transplant I felt so incredibly well. My head was clear, the swelling was gone, and I wasn’t tired,” Sal says. “I think we’re going to really celebrate my next birthday.”

About the P/SL Transplant Center

For patients who are deciding where to have a transplant, Sal says the P/SL Transplant Center came highly recommended. It’s an approved United Network for Organ Sharing (UNOS) program and the kidney and liver transplant team has performed more than 2,700 transplant surgeries to date. The Kidney Transplant Center also stands out because it was one of only 53 centers in the U.S., and the only one in Colorado, to receive a 5/5 score by the Scientific Registry of Transplant Recipients (SRTR) in 2017 for outstanding patient and graft survival rates.

P/SL Excels at Liver Transplants Too

Cross Blood Transplants

Dr. Tom Heffron, P/SL Transplant Center

Dr. Tom Heffron

Another service attracting transplant patients to P/SL is its cross-blood transplant program led by Dr. Tom Heffron, Transplant Surgeon and Surgical Director of the Transplant Program. Used primarily with liver transplants, Heffron is one of just a few doctors in the country performing transplants on a routine basis across blood groups for adults and children.

Generally, a recipient receives a transplant from an organ donor with the same blood group or a compatible blood group. But frequently, Heffron says, patients become very sick while waiting for a donor organ with matching blood type.

“To increase a liver patient’s likelihood of receiving an organ, I list for all blood groups,” Heffron says. “People have an excellent survival rate with cross blood transplants.”

Hepatitis C Treatment

Likewise, P/SL has a team of medical experts that specialize in treating patients with hepatitis C, a viral infection that causes liver damage and frequently liver failure, which requires a liver transplant.

Dr. Clark Kulig, Hep C, P/SL transplant Center

Dr. Clark Kulig

“Liver disease is sneaky. Many people don’t even know they have hepatitis C since they don’t exhibit any symptoms,” says Dr. Clark Kulig, a Transplant Hepatologist with P/SL. “Our team helps patients manage their medical problems and the reoccurrence of liver disease, since the virus comes back even with a new liver.”

Kulig and his team treat hepatitis C patients at different stages of liver damage before and after a liver transplant. Kulig and the Centers for Disease Control recommend that people born between 1945 and 1965 get screened. A simple blood test can determine whether you have hepatitis C. Through early detection and treatment, liver damage and scarring can be minimized, and in some instances, people can even be cured.

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