Henry Ford Health Transplant Notes 2024 Vol. 1

2024 Vol. 1

Transplant Notes

henryford.com/transplant

Michigan's Transplant Program Expanding Network of Outreach Clinics

Reflections from the desk of Dr. Marwan Abouljoud It is exciting to share the many advances and innovations happening within the Henry Ford Transplant program. It is the hard work of the entire team that makes it possible for us to be Michigan’s most comprehensive transplant program.

Static cold storage of a donated liver, lung, or heart was the norm. Through normothermic machine perfusion (NMP) maintaining organ temperature of 34 degrees centigrade reduces preservation injury, improves graft viability, and ex vivo assessment of graft viability before transplantation is improved.

The organ stored at a warmer temperature allows the organ to immediately function upon transplant and is often healthier after being perfused.

This warm storage with perfusion can extend preservation of the organ for 24 hours although most surgeons prefer16 hours but within a range from 8 to 16 hours. This technology means more usable organs will be available and with less time on the waiting list recipients will not be as sick when receiving an organ.

Henry Ford Hospital’s long-term partnership with the nephrologists at Children’s Hospital of Michigan meant an adult living donor was able to donate a kidney to 19-year-old Adam Klenow, who has been a long-time pediatric patient at Children’s.

Henry Ford Transplant surgeon Dr. Atsushi Yoshida removed Jessica Sorrenson’s kidney at Henry Ford Hospital and Dr. Ahmed Nassar transplanted the kidney at Children’s Hospital. Dr. Dean Kim continues to lead the Children’s program providing his surgical expertise to supplement and support the medical services of the Children’s nephrology program. The Henry Ford Transplant team has also supported the Children’s team for complex liver transplantation when needed and we hope to expand those services.

In Southeast Michigan, Henry Ford has the most active left ventricular assist device (LVAD) program. Dr. Jennifer Cowger, with her expertise in mechanical circulatory support, has become our leader in both research of LVAD and use of the heart pump to support patients while bridging the gap to heart transplantation. The story of patient Nancy Cummins is an example of how her health made her ineligible for a heart transplant, and LVAD gave her the time to improve her health while living a quality life on LVAD. Nancy’s story of dedication to improve her life, while on LVAD, is an inspiration.

Henry Ford has some of the longest-living LVAD patients in the country at 5 years which surpasses national averages.

Marwan S. Abouljoud, M.D., FACS

“It seems fair that with our expertise, experience, We were third in the world to be asked to participate in clinical trials of the expansive and growing TransMedics™ Organ Care System (OCS) program we refer to and first in the Midwest. Use of OCS for liver, heart and lung means the donated ourselves as Michigan’s organ is immediately connected to the respective OCS device for warm storage Transplant program.” and perfusion during transportation.

During warm storage, the organ is constantly monitored, receiving oxygen, nutrition, and medication as needed.

Dr. Hassan Nemeh and Dr. Ahmed Nassar transplanted a new heart and liver for Raleigh Howard, Jr. who had been turned down for transplant at other hospitals. While Dr. Nemeh transplanted the heart, the donated liver was connected to TransMedics™ OCS – Liver, ensuring it would be healthy and ready for transplant a few hours later. It began to function immediately because it was near body temperature and received oxygen and nutrition while on the pump.

We are humbled to present the 2022 Outcomes Report that indicates the lives of 288 patients were changed through transplantation and 30 people became living donors. We honor each of the donors, their loved ones and our team of experts and specialists who made this happen. The Center for Living Donation has also been at the forefront in their continued support including organizing the largest kidney paired donor chain that included six pairs of living donor to recipient— that’s 12 patient’s lives that were changed.

The Outcomes Report highlights how the Henry Ford Transplant program is one of the most comprehensive transplant programs in Michigan. Our expertise in heart, lung, kidney, pancreas liver and Michigan’s only intestine and multivisceral transplantation could only be possible through the efforts of our dedicated team. We continue to expand our team as the need for our expertise continues to grow.

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Dr. Cowger and thoracic organ transplantation surgeon Dr. Hassan Nemeh work in lockstep to make this an evolving space in heart medicine with mechanical support options to treat without surgery. Dr. Cowger will soon take a national role in the research of LVAD devices.

Perhaps the first in the country is our program to support transplant patients through their journey was the creation of the Transplant Living Community (TLC) by our patient Beth Rubinstein, a 2007 liver transplant recipient. She saw a need for patients to understand the nonclinical aspects of their experience and developed a tool named, ACES® that provides education pre- and post-transplantation. For the last 15 years, this tool for education is delivered through the TLC by an army of volunteer ambassadors at Henry Ford, now under the leadership of Jackie Roman, transplant social worker and Dr. Kelly Bryce transplant clinical health psychologist.

Throughout this publication you will learn from several of our patients about their life-altering experiences and understand the impact the expertise of every member of the Henry Ford Transplantation program has given to our patients throughout the state of Michigan.

It seems fair that with our expertise, experience, expansive and growing program we refer to ourselves as Michigan’s Transplant program.

Normothermic machine perfusion advances transplantation The preservation of organs for transplantation has historically been by static cold storage (SCS) between donation and transplantation. In SCS, donated organs often become damaged from the cold preservation as the organs do not receive enough oxygen or nutrition and often causes reperfusion damage. Normothermic machine perfusion (NMP) has changed the method of ‘storage’ providing more viable organs for transplant, specifically for donation after circulatory death (DCD).

Ahmed Nassar, M.D.

As the first transplantation center in Michigan to research and adopt perfusion technology, the Henry Ford transplantation team chose the organ care system (OCS), TransMedics™ OCS - Liver, TransMedics™ OCS - Lung and TransMedics™ OCS Heart portable extracorporeal warm perfusion technology. “It is modular, mobile, and preserves or improves organ quality. The organ can immediately be monitored for lactic acid, bile production Hassan Nemeh, M.D. [liver] and blood flows, and medication can be administered to improve blood flow,” explained Marwan Abouljoud, M.D., Benson Ford Endowed Chair, director, Henry Ford Transplant and Hepatobiliary Surgery. “During perfusion the organ maintains a slightly lower body temperature. When transplanted the organ does not need to warm and functions once the clamps are released.”

The TransMedics™ Organ Care Systems were developed in the United States and is the first system that is fully mobile, making harvesting organs from further distances a possibility. This will increase the utilization of donor organs for the treatment of end-stage heart, lung, and liver failure. Dr. Abouljoud explained that “the optimum time for an organ to be on pump seems to be 8 to 16 hours, after that the benefits are unclear yet there is a point where damage can occur.”

Damani Howard became the primary caregiver for Raleigh Howard following transplant surgery

Detroit barber benefits from normothermic machine perfusion Raleigh Howard, Jr., 51, of Detroit, was 35 years old when he learned he had an enlarged heart that over time would cause his liver to fail. “I didn’t really feel bad, it seems like my body kind of adjusted. I figured I was just tired and winded.”

TransMedics™ OCS - Liver

Fast forward to Spring 2023, Raleigh learned the damage done to his organs meant he needed a donor heart and liver. He was immediately put on the waiting list. What followed, as he recalls, were long days in the hospital, being on heart pump and confined to a hospital bed while he waited.

Ahmed Nassar, M.D., liver transplant surgeon, was involved in early normothermic machine perfusion research, and spent seven years at Cleveland Clinic in surgical training that also included conducting research on liver perfusion and bile duct injury, described, “The liver on the perfusion machine is metabolically active being provided blood, nutrients, and medications. The organ gets the same amount of blood as it would within the body. The liver even starts making bile as if it were in the body. Because the liver is kept close to body temperature rather than on ice for six or seven hours, it starts to function immediately.”

Hospitalized for a couple months while he waited for a heart and liver, “I worked hard to keep a good attitude with the help of my good family, good friends, and the Xbox.” Every day Raleigh laid in bed he felt like he lost three days’ worth of strength. Raleigh recalls the great staff on his floor at Henry Ford Hospital helping him to stand using a table, “It felt

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Dr. Nassar said, “I would call NMP one of the most important advances in liver transplantation over the last two decades.

It will result in more organs being available for transplantation and more lives saved.” For liver transplants, NMP is safer and expands the pool of available liver allografts, and the recipient is often healthier when receiving the liver sooner. In fact, “patients are more stable because a functioning liver is transplanted and the healing process starts almost immediately,” explained Dr. Nassar. Yet, he cautions, “The technology is relatively new but our expectation, as more data becomes available, we will see patients experience a better recovery time.”

Dr. Nemeh explained that OCS provides a valuable service to the transplant team. “Sometimes we have a great organ and no one is available to harvest it, or the implanting surgeon can do it, but they have a delay. That is when we utilize the TransMedics™ national service, where their surgeons are sent to evaluate the quality of the donor organ. In constant communication with the surgeons, we decide together if the organ is appropriate. If so, it is harvested and put on the mobile TransMedics™ perfusion machine and brought to our operating room in a timely fashion. This service helps to protect the patient’s opportunity to receive the organ.”

For the future, Dr. Nassar sees the possibility a marginal liver can be medically and genetically modified by decreasing the amount of fat in the liver and improve the immunological response while it is on the pump further extending the number of organs available for transplantation.

Like Dr. Nassar, Dr. Nemeh is cautious about outcomes, but as the number of cases increase the outcomes will become evident. “At this time, the data is consistent when we use the machine; we face less primary graft failure rates. I can say that I am very pleased with the quality of the product, especially from the lung perspective.”

TransMedics™- Lung Hassan Nemeh, M.D., surgical director of Thoracic Organ Transplant at Henry Ford Hospital shared, “The major attraction to NMP is the potential increase in the donor pool in terms of ischemia time. We can tolerate a longer travel time of an organ.”

He explained, “The data is consistent when we use the machine, we face less primary graft failure rates. Some subset of patients like, complex operations or pulmonary hypertension, does put the patient at higher risk of development or primary graft failure however NMP is better for recipients who are very high risk, whether it’s a very complex operation itself or the patient has severe pulmonary hypertension. OCS will be used for this subset of patients, if over time I can prove to us first and then to the community at large that it’s a safer approach.”

TransMedics™- Heart For the heart, Dr. Nemeh explains, “We’ve been using the perfusion machine to extend the ischemic time. Normally our comfort zone is about four to five hours, but we prefer four hours. If we have a great donor heart the ischemic time might go beyond the five hours, when the OCS is used to extend the validity of the organ.”

Next use for the OCS in heart transplantation is DCD heart harvest, we are working out the safe protocol as a second purposeful use of the machine. And the third benefit for the heart is again the use of the national TransMedics™ surgical team to harvest and perfuse the heart while delivering to the operating room.

Early treatment of Sarcoidosis can prevent organ failure Sarcoidosis (also called sarcoid) is a rare disease that causes severe inflammation in one or more of the body’s organs. The trigger for the sarcoid is believed to be partly environmental and partly genetic in etiology. Signs and symptoms may include fatigue, cough, shortness of breath, joint pain, eye pain or redness, and/or skin rashes. For the heart, patients can have electrical abnormalities or even heart failure.

When treatments are not successful or a confirming diagnosis is sought, patients are often referred to the Sarcoidosis clinic at Henry Ford Hospital.

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The Henry Ford Sarcoid Multidisciplinary Team is composed of Sarcoid specialists in Pulmonary, Cardiology, Dermatology, Rheumatology, Hepatology, Neurology, and Advanced Imaging.

Their goals are to identify patients with sarcoid rapidly and to begin treatment early, with the hope of avoiding irreversible organ failure. During monthly meetings, the challenging cases are reviewed, and decisions are made on interdisciplinary care with confirmed or suspected Sarcoid of any organ.

“Similar to cancer staging, we stage the extent of the disease and devise a patient-specific treatment and monitoring plan to monitor disease response and disease recurrence, respectively.

Leaders in robotic kidney transplantation Robotic surgery has transformed the way surgery is performed. From its beginnings within urological surgery and general surgery, robotic surgery has since moved to more complex surgery within the field of transplant surgery. The operation of a kidney transplant has not changed in principle for over 60 years. Kidney transplantation is moving into the Atsushi Yoshida, M.D. modern era allowing transplant surgeons to do complex procedures in a minimally invasive way. At present, both donor nephrectomy and kidney transplantation are being performed robotically assisted.

As the second program in the nation to perform robotic assisted kidney transplantation, 10-20 robotic transplants per year are performed at Henry Ford Hospital.

The program is led by Atsushi Yoshida, M.D., division head for Transplant Surgery, surgical director of Liver Transplantation, and director of Transplant Robotic Surgery, Henry Ford Transplant.

Use of the robot, as directed by the surgeon, allows placement and clear view of the surgical field with up to eight times the magnification. It also allows the surgeon to more easily adjust instruments during the procedure.

Dr. Yoshida explains that the “advancement in technology, including high-definition images, television screens and artificial intelligence (AI) has allowed us to do what we initially thought was impossible or difficult. For example, complex liver surgery, robotic kidney nephrectomy and complex reconstruction post kidney and liver transplant, like ureteral reconstruction, are the benefactors of advancing robotic surgery.”

Most patients with sarcoid usually only need close monitoring and intermittent treatment with immunosuppressive medications. Unfortunately, some develop severe organ failure, especially if the diagnosis is made very late,” explains Jennifer A. Cowger, M.D., section head of Advanced Heart Failure, Transplant, and Mechanical Circulatory Support, member of the Shock, Structural, Sarcoid and Amyloid Programs.

Through the use of AI, Dr. Yoshida notes the entire database of all robotic surgery is centralized in the da Vinci® company’s headquarters. “With this data, they can tell you how many movements you make in a given case, how efficient or inefficient you are. They’ll tell you what instruments surgeons across the United States use in the same procedures. This is helpful when judging which of the suggested instruments are best to use or consider for future use.”

Dr. Yoshida shared that in addition to learning through AI, social media has become very useful for surgeons to learn techniques much faster through videos. “We share videos easily between surgeons. We can learn from each other.

So, most surgeons are no longer just learning it from the hospital but learning through video because we can see what other surgeons are doing.”

Historically, Dr. Yoshida shared that robotic kidney surgery started about 10 years ago with the da Vinci® robotic surgery system and today Henry Ford’s team of robotic transplant surgeons are at the forefront of robotic surgery.

“Our goal is to make other surgeons aware of the procedures we have perfected. We have been called to train about 70% of robotic surgeons across the United States to perform this minimally invasive procedure.” Looking to the future, Dr. Yoshida anticipates that robotic liver transplantation is not too far away, with pancreas potentially being next.

Henry Ford Hospital has the most advanced robotic-assisted kidney transplant program in the country. To refer a patient to the Henry Ford Transplant program, call (313) 916-1269.

on more than six patients and at least five patients have benefited from a heart pump called a left ventricular assist device or LVAD.”

Jennifer Cowger, M.D.

Dr. Cowger notes that “Henry Ford has performed a combined heart and lung transplant on a sarcoid patient who is now five years out and doing well; a heart-kidney transplant on a patient in 2018; and heart transplants alone

The National Sarcoid Consortium, a group of national experts who get together virtually to discuss disease diagnosis, challenging cases, and research topics has been formed under Dr. Cowger’s leadership. Funding to support a national trial is being worked on. “I founded this national group using the knowledge gained through the development and treatment of patients at Henry Ford Hospital,” says Dr. Cowger.

To refer a patient to the Sarcoid Clinic, please call (313) 916-2966. henryford.com/transplant | 5

Center for Living Donation team

Center For Living Donation: donors provide a living tribute Changing lives is the goal of the Henry Ford Center for Living Donation (CLD). The generosity of living donors impacts the life of their recipient, their family, and friends in extraordinary ways.

The living donor also finds their gift changes their life in amazing ways, too.

Jason Denny, M.D. Director of Center for Living Donation, Surgical Director of Living Kidney Donation

Rohini Prashar, M.D. Medical Director, Living Donor Kidney Transplantation, Associate Medical Director, Center for Living Donation

Jason Denny, M.D., director of the Center for Living Donation and surgical director of Living Kidney Donation explained that over a four-month period, the largest kidney paired donor chain occurred.

“It started with an altruistic donor, who was not a match for their recipient. That lead to six pairs of living donor to recipient—that’s 12 patients and a lot of coordination by our entire team.”

Dr. Denny explained, “We are using more robotic procedures for living kidney donation which can be better for the patient.”

In 2022 there were 39 living donations, and “with more awareness about living donation, how safe it is for the donor and how it changes both the living donor and recipients lives we hope to see that number increase.”

Shunji Nagai, M.D. Surgical Director, Intestine Transplant and Rehabilitation; Director, Transplant Surgery Research

Deepak Venkat, M.D. Medical Director, Living Donor Liver Transplantation

The CLD is multi-faceted by providing support in many aspects of the donor’s life. Through a team of doctors, advance practice providers, nurses, social workers, staff, and former donors, this group comes together to create the experience living kidney and living liver organ donors deserve. The support also comes in many forms including education, clinical, and financial.

Education The CLD team provides education and support to answer every question about donation. Maria Zanini, R.N., MSN, CNP, clinical manager, Center for Living Donation, explains, “It’s hard to ask others if they might be willing to consider donating an organ, we acknowledge that and support and navigate patients through that process.”

Maria Zanini, R.N., MSN, CNP Clinical Nurse Manager, Donor Nurse Practitioner

Nemie Beltran, R.N. Living Liver Donor Nurse Coordinator

Once a person has agreed to be tested, “We work with potential donors to inform them about screening and how the process of living donation works. We explain the risks involved with surgery and always prioritize their comfort and safety.”

Clinical Dr. Denny explains, “From a clinical perspective, the health history of the living donor is known well in advance, which allows significantly more screening and planning by medical staff. What we know from experience is that donated organs from a living donor typically last longer and work immediately. A patient who has been on a waiting list is often sicker, which effects the rest of the body, both of which can be avoided with living donation.”

Emily Cox, R.N. Living Kidney Donor Nurse Coordinator

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Meghan Whittaker, R.N. Living Kidney Donor Nurse Coordinator

Living donors: Jessica and Mark For living donors like Jessica Sorensen, of Clarkston, “The Center for Living Donation team taught me about living donation and what that would mean for my physical body, plus emotionally and psychologically. Dr. Yoshida taught me about the difference between robotic surgery and traditional organ removal of my kidney. Emily Cox, my transplant coordinator, supported me through each step and we still talk to this day.”

Jessica Sorensen, living donor with Adam Klenow, kidney recipient

Atsushi Yoshida, M.D. FACS, division head, Transplant and Hepatobiliary Surgery, robotically removed Jessica’s kidney at Henry Ford Hospital, he said, “It’s very unusual to have people donate a kidney to someone else besides a member of their family, and I think we want to try to encourage that more because it’s a safe operation.” Recovery time for a living donor is 2 to 4 weeks, with no heavy lifting for up to 8 weeks.

the procedure, went over my testing numbers, and checked out my overall wellness,” Mark shared. As a living donor for an advanced split-liver transplant, the liver is unique in that it is able to regenerate. The portion of the liver that is remaining in the donor grows larger to almost the original size of the liver prior to donation. The same regenerative property exists in the portion of the liver that is implanted in the recipient.

Like Jessica Sorrenson, Mark focused on his physical condition, his diet and how he would handle the emotional aspect of the donation. Both their families were extremely supportive of their decision to become a living donor.

Mark says, “Life is precious. You live to a certain age, and you watch people near and dear to you die. It gives you kind of an impotent sorrow. I saw the opportunity to push that clock back for my brother-in-law, and I wasn’t going to let that slip by without trying. This experience has brought all of us closer.”

Jessica says she is “grateful for the process, it was a gift— in the heart­—that I gained from going through it. I gain no medical benefit, but if I could and the opportunity came I would do it again.” For the living donor, the recipient’s health insurance covered all of Jessica’s medical expenses.

The recipient of Jessica’s kidney donation was 19-yearold Adam Klenow. His father, Dennis and Jessica worked together as teachers for over 20 years and even taught each other’s children. “When I saw the email our school put out on behalf of Dennis, there was no question. I knew I wanted to be tested and hoped to be his donor.” Jessica worked with the Center for Living Donation for all her testing, “When I found out I was an exact match, it was an overwhelming feeling. I knew I would donate, no question.”

Dave Galbenski, living liver recipient

Living donor recipients: Adam and Dave For the patient who might be on a waiting list for years, a living donor transplant can mean receiving a transplanted organ before becoming significantly ill. “For the patient, this means less chance of rejection and a quicker and healthier recovery,” explained Dr. Denny.

Adam Klenow, of Clarkston, qualified for a donation at age 17, but when he turned 18 the criteria changed, which meant Adam was on the waiting list for two more years. Dennis said, “Adam just got sicker, he slept for 13-15 hours a day.

We watched as he got worse.”

Mark Dybis, living liver donor

When Mark Dybis, of Grosse Pointe Woods, learned his brother-in-law, Dave Galbenski, of Grosse Point Shores had been diagnosed with a rare liver disease, primary sclerosing cholangitis (PCS), Mark and his wife Karen did not hesitate to be tested, Mark was the match. “I met with Dr. Marwan Abouljoud and his team at Henry Ford Hospital. We discussed

Still considered a pediatric patient, a transplant surgery partnership with Children’s Hospital of Michigan allowed transplant surgeons from Henry Ford Transplant to give Adam the kidney Jessica donated. Henry Ford Hospital Transplant Surgeon Ahmed Nassar, M.D., received Jessica’s kidney for transplantation. “It was an exact match, healthy and began producing urine immediately. “The procedure went smoother than we anticipated, reestablishing the blood flow is the critical part of the operation. When the kidney pinked up, we all gave a cheer of joy for Adam,” said Dr. Nassar. “There are 2,000 people on the waiting list for a kidney, not all will make it. Living donation does save lives, we just need more awareness.”

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Giving through fundraising

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The Center for Living Donation (CLD) also counsels on the financial considerations in living donation. The team includes financial specialists to help living donors navigate insurance and other resources for expenses.

“With tons of energy, Adam was dancing around his room the day after surgery surprising all of us. We went to visit Jessica a week later,” Dennis shared. Jessica says her donation gave Adam “his life back, a life without being on dialysis. I hope those who are considering a living donation will not hesitate.”

It is through the generosity of living donors, recipients and their communities that support the financial needs of patients to cover expenses not covered by insurance or housing costs. Over the last year there have been several gifts and events:

Dave Galbenski, Grosse Pointe Shores, was told that primary sclerosing cholangitis, a rare autoimmune disease, had damaged his liver. The only treatment is a liver transplant, “It was a tough diagnosis,” Dave recalls.

An individual donor provided funds to completely renovate and bring high tech to the patient rooms used solely by transplant patients, a conference room for patients and physicians to meet and a place to showcase the stories of the patients.

In 2022, a grass roots effort by a group of high energy teens from Adams High School, Rochester High School, and Stony Creek High School, chose to donate to The Center for Living Donation from their Tri-High Charity Week. It was in honor of their cherished teacher Mr. Zolinski’s sister, Melissa Zwolinski, who received a liver transplant several years ago. “These young people made a difference, I was very moved by the kids and their hard work,” explained Maria Zanini. “They raised $83,568 for the CLD. When people are moved, there are no barriers.” Dr. Denny added “the energy these kids brought to the fundraising efforts was invigorating and we really appreciate what they did to help others.”

Members representing Rochester high schools presented a donation of $83,568 to Henry Ford Center for Living Donation’s Medical Director Dr. Rohini Prashar, and Clinical Nurse Manager Maria Zanini.

Those interested in creating a fundraising event or making a financial contribution to support the Center for Living Donation, please contact Maria Zanini at (313) 916-8286.

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Preparing for his surgery, Dave prepared a vision board and a play list, “they helped shape my mind and energy for the surgery and recovery.”

Our families were so supportive, “I can’t even describe the emotions I felt when I learned Mark would be my donor. It was an incredible joy and tears.” Dave says, “When a living donor provides an organ, it’s a win-win when the recipient receives a much-needed organ and frees up another organ that can be given to another,” said Dave.

Dave recalls how “amazing it was to see the number of skilled professionals in the operating room. Everyone was focused, but kind and accommodating. They understand what patients are going through and help support us, but they have an intense focus to get it right.”

Fully recovered, Dave’s liver regenerated in a couple of months. “I got a second chance at life,” he says. He’s even run a half marathon after an uneventful recovery.

Since fully recovering from his transplant, David and his wife, Lynn, have founded the Living Liver Foundation with the goal of creating awareness and increasing the number of living donor liver and kidney transplants performed each year at Henry Ford Hospital and at centers around the Meeting for the first time is Cynthia (L) who received a living kidney donation from Lindsey, who are joined country. In July 2023 their

by Dr. Marwan Abouljoud. foundation co-sponsored another fundraising event with the Center for Living Donation. Held at Jimmy John’s field in Utica, the purpose of the event was to honor living donors, bring awareness through education to inspire more to consider living liver or kidney donation. Dr. Denny explained, at this event “all the living donors were honored, and we revealed several donor pairs to each other, it was very emotional.”

In addition to the foundation being partner-sponsor at the Jimmy John’s event, David and Lynn are also working legislatively to make the living donation process easier for all who are willing, and producing awareness events during 2023 in Michigan, Ohio, and Georgia.

Website: www.livingliver.org.

If you or someone you know is considering becoming a living donor, contact the Henry Ford Center for Living Donation and submit your inquiry to: www.henryfordlivingdonor.org

TLC = Transplant Living Community Beth Rubinstein received the gift of life through a liver transplant in 2007. On the day she learned of her transplant, she was scheduled to be admitted into home hospice care.

She never made it home that day, but she did end up in the operating room at Henry Ford Hospital, where the transplant team worked to change the direction of Beth’s life.

Following her transplant, a curious Beth wanted to learn more about both sides of the life/death equation of organ donation, but that information would come not from the medical community rather through unique lifestyle adaptation and the development of character strength and life balance. So, Beth enrolled in the Gift of Life Volunteer training program, where she learned that organ donation brings hope to the donor family, and that something good can be realized out of tragedy as their loved one would save the life of another. She then attended Henry Ford’s Hospice Volunteer training where she realized her innate lived experience provided a deep understanding of the emotional and psychological hurdles of life over death. This was the lightbulb moment, when she realized the missing piece of walking people through the transplant process—from the lifestyle perspective.

Beth Rubinstein educates others on the importance of education for transplant recipients

Beth recalls “exhausting Dr. Moonka with endless questions.

I finally asked him for the transplant recipient’s owner’s manual to learn how to exist as an immune suppressed person and create a new normal lifestyle.” In answer to Beth’s question, “Dr. Moonka challenged me to write the manual.”

After some research, Beth found four primary elements that all medical personnel wish for their patients and families to follow. The ideal patient would have a great attitude, be compliant, engage in exercise, and have a consistent support team. She then turned to PubMed and found over 90,000 published papers, suggesting the benefits of these components, but nothing highlighted the benefit of combining all four of these elements together.

Through this research ACES® was born, which stands for Attitude, Compliance, Exercise, Support. ACES® provides a delivery vehicle for non-medical, lifestyle education that

complements formal medical care. ACES® was created in the patient voice to assist patients, families, and caregivers with organizing complex medical information into smaller actionable units. It provides structured parameters that are supported by use of a personal health record. These tools were created by the Transplant Living Community (TLC) to help the patient navigate the health system in an easier way that benefits both the patient and caregiver after discharge. The TLC curriculum defines what ACES® are and how to live each ACES® category Kelly Bryce, Ph.D. from a lifestyle perspective.

Now 15 years later, ACES® is the tool that provides education pre- and posttransplantation, delivered through an army of volunteer ambassadors known as the Transplant Living Community (TLC) at Henry Ford.

“TLC currently has 14 highly trained volunteer ambassadors, each who Jackie Roman, MSW, LMSW bring their personal lived experience and the extensive training to each transplant patient they meet,” explains Kelly Bryce, Ph.D., Henry Ford Transplant clinical health psychologist.

“Beth gave an extraordinary gift that lives on through the creation of ACES®.”

The TLC ambassadors are transplant recipients who are at least 12 months post-transplant, living donors, or caregivers. Jackie Roman, MSW, LMSW, Henry Ford Transplant social worker, shares “the ambassadors deliver education to recipients at several touchpoints post-transplant and prior to discharge, and this includes individual family and personal meetings. They share their experiences and bring them a goodie bag with tools to help them succeed.” Further she notes, that the “our transplant medical community truly supports the efforts of the ambassadors.”

The daughter of recent liver transplant patient Susan H. shared, “It was so helpful to have one of the ambassadors talk to me and my mom before she was discharged.” Susan said, “We were feeling a little uncertain about our very next thing, but TLC smoothed out the potholes that we thought were coming. I’m so glad that we came to Henry Ford for my transplant, it has been a world of difference in my care here.”

To become a volunteer ambassador, please email TLC@hfhs.org or call (313) 916-3612 to leave a voice mail for further information about the TLC Ambassador volunteer program or apply online. henryford.com/transplant | 9

Double lung transplant saves the life of teen with EVALI Daniel Ament, 16 at the time, is thought to be the first double lung transplant in the world after suffering what the U.S. Centers for Disease Control and Prevention calls EVALI, or E-cigarette or vaping-associated lung injury.

Daniel was admitted to Ascension St. John Hospital in Detroit on Sept. 5, 2019, with pneumonia-like symptoms.

His condition quickly deteriorated as his lungs filled with fluid and dead tissue. He was transferred to the Children’s Hospital of Michigan on Sept. 17, where he was hooked up to extracorporeal membrane oxygenation (ECMO) device to allow his heart to rest as he struggled to breathe.

Otherwise healthy, Daniel, a varsity swimmer who also ran cross country and track at Grosse Pointe North High School, continued to get worse. Doctors contacted Lisa Allenspach, M.D., pulmonologist and the medical director of Henry Ford’s Lung Transplant Program, to determine if Daniel would be a candidate for a lung transplant.

Lisa Allenspach, M.D.

Hassan Nemeh, M.D.

Overall, 82% of EVALI patients reported using any tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, product (including 33% with exclusive THCcontaining product use), and 57% of EVALI patients reported using any nicotine-containing product (including 14% with exclusive nicotine-containing product use).

Daniel says, “It is my mission to use my life-changing experience to educate people about the dangers of vaping and other substance abuse and to improve overall mental wellness through providing ways to cope with the pressures of being a teenager.”

Themistokles Chamogeorgakis, M.D.

“At that point, Daniel was so sick that he wouldn’t live without a lung transplant,” Dr. Allenspach said. “It was his only hope. And because he was so young, we wanted to give him a chance to survive.”

At Henry Ford Hospital, Daniel was evaluated and placed on the organ transplant waiting list on Oct. 8, 2019. The lung damage due to vaping was so severe—and he was so close to death—that he immediately shot to the top of the transplant waiting list.

On Oct. 15, 2019 Henry Ford Health Cardio-thoracic surgeon Hassan Nemeh, M.D., surgical director of Thoracic Organ Transplant, performed the transplant with surgeons Dr. Themistokles Chamogeorgakis and Dr. Daizo Tanaka in the successful, six-hour double-lung transplant.

“After Daniel’s surgery, we discussed how this life-changing event could become a beacon of change for others,” said Dr. Nemeh. “As I have said from the start, vaping is an absolute evil that should be stopped. Daniel’s bravery coming forward to use his story to show why others should quit vaping should be commended.”

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The use of e-cigarettes is unregulated with some components of the vape products more damaging than others. The number of EVALI cases are increasing. As of January 14, 2020, a total of 2,668 hospitalized EVALI cases had been reported to CDC and there have been 60 deaths. Median patient age was 24 years, and 66% were male.

Daizo Tanaka, M.D.

Daniel is committed to sharing his story publicly and launched www.Fight4Wellness.com, a non-profit organization that will encourage young people to live a healthier and happier lifestyle and improve overall mental wellness with training for counselors, coaches and parents to provide alternatives for coping with the pressures of being a teenager void of substances.

www.MyLifeMyQuit.com, a program designed to help teens stop vaping henryford.com/services/tobacco-treatment Henry Ford Health Tobacco Cessation program for those vaping nicotine henryford.com/addiction Henry Ford Health Addiction Services for those vaping THC

First double lung transplant post-COVID Believed to be Michigan’s first post-COVID double-lung transplant recipient, a pregnant Jackie Dennis, then 31, of Wyandotte survived. The ferocity of lung damage caused by the coronavirus was just being recognized by medical communities across the country.

On Nov. 20, 2020 Jackie’s husband Ricky drove her to the Emergency Department at Henry Ford Wyandotte Hospital with the typical COVID symptoms where she was admitted and received remdesivir, steroids and heparin.

One week later, suffering from preeclampsia, doctors induced her labor at 36 weeks, one month before the baby’s expected due date.

Two days after giving birth on Nov. 27, Jackie developed COVID-related pneumonia and received convalescent plasma infusion twice, however her breathing deteriorated and she required a ventilator, high amounts of oxygen to maintain normal blood oxygen levels with high amounts of sedation and paralysis.

On Jan. 6, 2021 she was listed on the national organ transplant waiting list, in a final attempt to save her life. On Jan. 16, just seven weeks after the birth of her healthy daughter Mia Rose, Jackie received a bilateral lung transplant performed by the Henry Ford Hospital team led by cardiothoracic surgeons, Daizo Tanaka, M.D. and Dimitrios Apostolou, M.D. Hassan Nemeh, M.D., surgical director of Thoracic Organ Transplant at Henry Ford Hospital shared, “When things were not looking hopeful, the courage and persistence of the team to go aggressively with ECMO was important in the transition for Jackie to be able to receive a transplant.” He described the removed lungs as the “worst he’s ever seen.”

Lisa Allenspach, M.D., medical director of Henry Ford’s Lung Transplant Program, said, “We have all marveled at just how amazing and inspirational her progress has been. It has been a hard-fought battle on many fronts. Jackie’s positive attitude and will to survive combined with the persistence and skill of the surgeons and medical teams—everyone working together, that’s what makes miracles happen.”

Jackie shared, “No one expected me to leave the hospital so fast, but I had an amazing team of doctors and nurses—I had the best team—everyone was truly amazing.”

After being away so long, I just wanted to get home and be with my family. I missed my husband and baby so much.”

Jackie Dennis

On Dec. 8, Jackie was transferred to the intensive care unit at Henry Ford Hospital, where a few days later she was placed on extracorporeal membrane oxygenation (ECMO), one of very few local hospitals with the machine and the expertise in its use. ECMO works like an artificial heart- lung machine by pumping blood from a patient’s body to an oxygenator which adds oxygen to the blood while removing carbon dioxide—ECMO replaces the function of the person’s own lungs.

After attempts to wean Jackie off ECMO were unsuccessful and with no signs her lungs would recover, the lung transplant team evaluated Jackie, with careful attention to ensure she was no longer carrying the COVID virus and that other organ systems were working well.

After one week in inpatient rehab, she returned home on Feb. 19—culminating a 91-day hospital stay. “She was completely off the ventilator and discharged from the hospital in less than a month, she made a record-breaking recovery. I really anticipated that Jackie would have been in the hospital for many months given how sick she was going into the transplant. She has really amazed us all,” Dr. Allenspach explained.

This November Mia Rose will be celebrating her third birthday. Jackie is a busy working mom, teaching high school special education and coaching cheerleading. Despite some medical setbacks she jokes, “if there’s something out of the ordinary, I am the one to have it.”

She gives kudos to her husband, Ricky Dennis, who was always there for her and recently took over the entire load when she was suddenly hospitalized for 10 days. She also praised her transplant coordinator Tracy for continuing to be there to support her. And although she was not aware of most of the events that occurred three years ago, she does know that the entire transplant team fought hard for her to live, “the way they care for me makes me want to care more, there are just no words to express my gratitude.”

Continued on page 13

henryford.com/transplant | 11

Nancy’s journey through heart failure to LVAD to heart transplant Nancy Cummins was only 34 when she was referred to Henry Ford Health and diagnosed with heart failure. It came as a complete shock. “There was no known cause,” says Nancy, a Detroit resident and certified public accountant who is now 40.

“I had never experienced any major symptoms.

It’s possible that some viral infections I had in previous years caused it. But once new symptoms arrived, they progressed rapidly. I started getting extreme shortness of breath, couldn’t walk even short distances and retained fluids,” Nancy says.

“I just felt like my body didn’t work right.”

Nancy’s advanced heart failure team at Henry Ford Hospital placed her on medication to help with her symptoms. She also participated in Nancy ran her first 5K with an LVAD. Henry Ford’s cardiac rehab program for 12 weeks.

However, her symptoms kept getting worse, received from Dr. Cowger and the advanced heart failure and in June 2020, her cardiologist, Jennifer Cowger, M.D., team and our team in preventive cardiology was a true recommended Nancy have a left ventricular assist device display of multidisciplinary care at its best.”

(LVAD) implanted to help her weakened heart pump blood The weight management team, which included both to the rest of the body. An LVAD can also serve as a bridge clinical exercise physiologists and dietitians, put Nancy treatment until an organ is available for transplant. on a healthy diet and exercise plan. “The program was easy to follow and I learned a lot from talking with the nutritionists,” Nancy says. A few months after starting the weight management program, Nancy also joined Henry Ford Health’s PREVENT (Prevention through Exercise and Nancy’s BMI, or body mass index—was too high and made her Education) Program. PREVENT participants exercise in a ineligible to be a heart transplant candidate. “I knew I had to medically supervised area under the guidance of exercise make my health my number one priority,” Nancy says. “After physiologists much like they did in cardiac rehab but are getting my LVAD, I was excited to do cardiac rehab again and taught to become more independent with their exercise start to get my strength back after being sick for so long.” and learn how to truly own it. PREVENT participants, like Nancy, have access to group fitness classes that include Nancy attended cardiac rehab three days a week for small group guided strength training and create a rapport 12 weeks. During this time, she participated in monitored, with the staff that further advances their fitness goals and medically supervised exercise sessions with exercise lifestyle changes through motivation and education. “All of physiologists and also attended educational lectures on the instructors and exercise specialists want people to be nutrition and heart disease. Dr. Cowger also referred Nancy in the best health they can be. It’s also a community, which to the Henry Ford Health weight management program. kept me motivated, because I would see the same people all the time.” Nancy says.

“This was really helpful to me,” Nancy says. “Dr. Dennis Kerrigan, who runs the cardiac rehab program, really wants After completing both the weight management and people to succeed.” Dr. Kerrigan says, “Nancy was one PREVENT programs, Nancy reduced her BMI to be in the of the first patients with an LVAD we worked with in our normal range and kept the weight off since then. With this weight management program. Historically, patients with dramatic change, she was also eligible to be added to the an LVAD have a very difficult time losing weight. However, heart transplant waiting list.

Nancy was very determined, and the top-notch support she

Cardiac rehab, PREVENT and weight management programs

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A new life with LVAD Running is just one of the ways Nancy enjoyed her new life with an LVAD. “I’ve never really been super athletic,” Nancy says. “In high school, I took dance classes and ballet but wasn’t into organized sports.

In PREVENT, the treadmill was something I could do consistently.

I started off pretty slow with running, only a minute or two at a time, but after a while, I could do more and more.”

First double lung transplant postCOVID Continued from page 11

She kept working at increasing her endurance. One day, Dr. Kerrigan noted there was a group of people at Henry Ford Cancer who are in the ExCITE exercise program, who were planning on running the Detroit Free Press Marathon 5K. He suggested that Nancy do the same.

In October 2022, Nancy ran the 5K. After she finished, she texted her care team: “I couldn’t have done it without all of you at cardiac rehab! And I may have been #996, but in the category of people with LVADs, I think I’m #1, lol!”

In February 2023, Nancy ran her second 5K, the Packzi Run in Hamtramck. “I was less nervous because I knew that I could finish it,” Nancy says. “This was more about having fun and enjoying the race atmosphere.”

A new life, new heart Nancy is quick to point out that she has experienced all three phases of a heart transplant journey. She praises her cardiologist Dr. Jennifer Cowger for sticking with her during the initial heart failure diagnosis, then the LVAD, and finally the heart transplant.

To her donor, Nancy says, “When the time is right I want to hear your story, to know how I received your heart, and to know your family.” In the meantime, Dr. Cowger will continue to see Nancy through her rehabilitation.

Back in cardiac rehab again, Nancy vows to get back into shape after surgery, “In 2024 I will be running another 5K, maybe it will be Detroit Free Press Marathon 5K again.”

Nancy had planned a trip to Paris for her 40th birthday, instead she received a new heart on April 30, 2023. “Paris is still going to happen, it’s just delayed,” says Nancy.

Jackie Dennis

Jackie believes that the donors and their families do not get enough recognition. She met her donor’s mother and two sisters, who continue to stay in close contact and celebrate Brittney’s life. She was told when getting her driver’s license shortly before her death that 18-year-old Brittney was asked if she wanted to be an organ donor. Her answer was “what am I gonna do with them after I’m gone.” Making the decision to be an organ donor made a difference for Jackie, she says gratefully, “I get to have a family and a kid.”

To learn more about Henry Ford Hospital’s Lung Transplant program, contact Michelle “Cookie” Crossley: mcrossl1@hfhs.org or call (313) 916-8304.

henryford.com/transplant | 13

Henry Ford Transplant program outreach clinics There are 30 Henry Ford Transplant program outreach clinics throughout Michigan, plus virtual consultations and visits are available.

Transplant Clinics Henry Ford Hospital 2799 West Grand Blvd.

Detroit, MI 48202 Henry Ford Specialty Center 5375 Hampton Pl Saginaw, MI 48064

Heart Advanced Heart Failure Clinic Ernst Cardiovascular Center Beaumont Hospital 3601 W. 13 Mile Road Royal Oak, MI 48073 Advanced Heart Failure Clinic Henry Ford Macomb Hospital 15855 19 Mile Road Clinton Township, MI 48038 Advanced Heart Failure Clinic Henry Ford West Bloomfield Hospital 6777 W. Maple Road West Bloomfield, MI 48322

Advanced Heart Failure Clinic Henry Ford Medical Center – Brownstown 23050 West Road Brownstown, MI 48138 Advanced Heart Failure Clinic Henry Ford Wyandotte Hospital 2333 Biddle Road Wyandotte, MI 48192

Liver, Small Bowel, and Multivisceral Hurley Liver, Small Bowel and Multivisceral Clinic 1125 Linden Rd., Suite 300 Flint, MI 48532 Grayling Liver Clinic 1200 W. North Down River Road Grayling, MI 49738 Jackson Liver Clinic Henry Ford Medical Center 3235 East Michigan Ave., Suite 102 Jackson, MI 49201

Advanced Heart Failure Clinic Providence Hospital 22250 Providence Dr., Suite 705 Southfield, MI 48075

Michigan State University Clinic 4660 S. Hagedorn Road, Suite 405 East Lansing, MI 48823

Advanced Heart Failure Clinic St. John Hospital and Medical Center 22201 Moross Road, Suite 356 Detroit, MI 48236

Liver, Small Bowel and Multivisceral Transplant Clinic – Grand Blanc 600 Health Park Blvd., Suite D Grand Blanc, MI 48439

Bloomfield Township Heart Clinic Henry Ford Medical Center – Bloomfield Township 1961 S. Telegraph Road Bloomfield Township, MI 48032

Liver, Small Bowel, and Multivisceral Transplant Clinic Henry Ford Medical Center – Columbus 39450 W. 12 Mile Road Novi, MI 48377

Jackson Heart Clinic One Jackson Square 100 E. Michigan Avenue, Suite 300 Jackson, MI 49201

Liver, Small Bowel, and Multivisceral Transplant Clinic Michigan Gastroenterology Institute 1650 Ramblewood Dr. East Lansing, MI 48223

Advanced Heart Failure Clinic Henry Ford Medical Center – Fairlane 19401 Hubbard Dr. Dearborn, MI 48126

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Liver, Small Bowel and Multivisceral Transplant Clinic – Saginaw 4690 McLeod Drive East Saginaw, MI 48604 Liver, Small Bowel, and Multivisceral Transplant Clinic 1000 East Paris Ave. SE, Suite 214 Grand Rapids, MI 49546 Liver, Small Bowel, and Multivisceral Transplant Clinic – Muskegon 1675 Leahy, Suite 324B Muskegon, MI 49442 Liver, Small Bowel, and Multivisceral Transplant Clinic Henry Ford Medical Center – Bloomfield Township 1961 S. Telegraph Road Bloomfield Township, MI 48302 Macomb Liver Clinic Henry Ford Medical Center – Lakeside 14500 Hall Road Sterling Heights, MI 48313

Lung Bloomfield Township Lung Clinic Henry Ford Medical Center – Bloomfield Township 1961 S. Telegraph Road Bloomfield Township, MI 48032 Hurley Lung Clinic 1125 S. Linden Rd., Suite 300 Flint, MI 48532 Grand Blanc Lung Clinic 8220 S. Saginaw St., Suite 800 Grand Blanc, MI 48439 Jackson Lung Clinic 900 E. Michigan Ave., Suite 105 Jackson, MI 49201 Grayling Lung Clinic 1200 W. North Down River Road Grayling, MI 49738

Henry Ford Transplant Outreach Clinic locations increase Michigan’s Transplant program continues to grow its state-wide network of Outreach Clinics to provide pre-and post-transplant care in areas where patients would otherwise not have access to transplant services.

“There is clear data that shows the further a patient lives from a transplant center, the opportunity to receive transplant services is significantly diminished and all the major transplant sites are in southeast Michigan,” explains Kimberly Brown, M.D., director of Outreach Clinics and transplant hematologist.

There are currently 30 Outreach Clinics established by organ. “Our specialists travel to these rural markets to provide care that doctors and patients in these areas might not consider,” says Dr. Brown. “Distance is one factor, but availability of specialists is another.”

Michigan State University Clinic 4660 S. Hagedorn Road, Suite 405 East Lansing, MI 48823 Novi Lung Clinic Henry Ford Medical Center – Columbus 39450 W. 12 Mile Road Novi, MI 48377

Kidney and Pancreas Bloomfield Township Kidney and Pancreas Clinic Henry Ford Medical Center – Bloomfield Township 1961 S. Telegraph Road Bloomfield Township, MI 48032 Hurley Kidney and Pancreas Clinic 1125 S. Linden Rd, Suite 300 Flint, MI 48532

Jackson Kidney and Pancreas Clinic Henry Ford Medical Center 3235 East Michigan Ave., Suite 102 Jackson, MI 49201 Michigan State University Clinic 4660 S. Hagedorn Road, Suite 405 East Lansing, MI 48823 Pontiac Kidney and Pancreas Clinic Michigan Kidney Consultants, P.C. 44200 Woodward Ave., Suite 2109 Pontiac, MI 48341 West Branch Kidney and Pancreas Clinic Dialysis & Nephrology Consultants 648 Progress St., Suite 101 West Branch, MI 48661 Ypsilanti Kidney and Pancreas Clinic 5333 McAuley Drive Reichert Building, Suite 403 Ypsilanti, MI 48197

The Outreach Clinics have a mixed delivery model using virtual visits when appropriate. “Henry Ford was one of the first providers to fully ramp up virtual care during the pandemic and we’ve kept it going,” explains Dr. Brown.

“Patients have gotten used to this mode of health care delivery and like it. We believe our virtual patients receive quality care with less travel and they show up.”

The network of Outpatient Clinics provide the opportunity to develop partnerships with the local health care providers for services like diagnostic testing, while the patient continues to stay close to home for these services.

To schedule your patient for a Transplant consultation, contact one of the Outreach Coordinators or call 1-855-85-TRANSPLANT.

henryford.com/transplant | 15

Meet the transplant team Abdominal Transplant Marwan S. Abouljoud, M.D. Benson Ford Endowed Chair Director, Henry Ford Transplant Program and Hepatobiliary Surgery Mobile Phone: (313) 433-9026 Email: MABOULJ5@hfhs.org Atsushi Yoshida, M.D. Division Head, Transplant and Hepatobiliary Surgery; Surgical Director, Liver Transplant; Director, Transplant Robotic Surgery Mobile Phone: (313) 657-6192 Email: AYOSHID1@hfhs.org Dean Y. Kim, M.D. Surgical Director, Kidney and Pancreas Transplant; Chief of Transplant Services, Children’s Hospital of Michigan Mobile Phone: (313) 610-7817 Email: DKIM3@hfhs.org Shunji Nagai, M.D. Surgical Director, Intestine Transplant and Rehabilitation; Director, Transplant Surgery Research Mobile Phone: (313) 461-9645 Email: SNAGAI1@hfhs.org Jason E. Denny, M.D. Surgical Director, Henry Ford Center for Living Donation Mobile Phone: (313) 205-9346 Email: JDENNY1@hfhs.org Lauren E. Malinzak, M.D. Medical Director, Transplant Inpatient Unit Director, Transplant and Hepatobiliary Surgery Fellowship Mobile Phone: (248) 891-7272 Email: LMALINZ1@hfhs.org

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Reena J. Salgia, M.D. Director, Liver Cancer Clinic Mobile Phone: (313) 812-8899 Email: RSALGIA1@hfhs.org

Abbas A. Al-Kurd, M.D. Sr. Staff Transplant Surgeon Mobile Phone: (313) 461-3788 Email: AALKUR1@hfhs.org

Syed-Mohammed R. Jafri, M.D. Medical Director, Alcoholic Liver Disease Program Mobile Phone: (313) 575-2293 Email: SJAFRI3@hfhs.org

Adhnan Mohamed, M.D. Sr. Staff Transplant Surgeon Mobile Phone: (313) 920-2181 Email: AMOHAME4@hfhs.org

Allyce N. Caines, M.D. Sr. Staff Transplant Hepatologist Mobile Phone: (585) 613-8577 Email: ACAINES1@hfhs.org

Ahmed Nassar, M.D. Sr. Staff Transplant Surgeon Surgical Director, Pediatric Liver Transplant, Children’s Hospital Mobile Phone: (313) 549-5434 Email: ANASSAR4@hfhs.org

Humberto C. Gonzalez, M.D. Associate Director, Hepatology Research Medical Director, Liver Metabolic Clinic Mobile Phone: (313) 205-0758 Email: HGONZAL1@hfhs.org

Transplant Hepatology Kimberly A. Brown, M.D. Associate Director, Henry Ford Transplant Program; Medical Director, Transplant Outreach Mobile Phone: (734) 945-9206 Email: KBROWN1@hfhs.org Dilip K. Moonka, M.D. Medical Director, Liver Transplant Mobile Phone: (248) 212-5447 Email: DMOONKA1@hfhs.org Yakir Muszkat, M.D. Medical Director, Intestine Transplant and Rehabilitation Mobile Phone: (313) 598-9331 Email: YMUSZKA1@hfhs.org Stuart C. Gordon, M.D. Section Chief, Hepatology Director of Hepatology Research Mobile Phone: (313) 282-3581 Email: SGORDON3@hfhs.org Deepak Venkat, M.D. Medical Director, Living Donor Liver Transplantation Mobile Phone: (313) 695-0593 Email: DVENKAT1@hfhs.org

Transplant Nephrology Rohini Prashar, M.D. Medical Director, Kidney Transplant Program; Associate Director, Center for Living Donation Mobile Phone: (313) 598-3912 Email: RPRASHA1@hfhs.org Milagros D. SamaniegoPicota, M.D. Director of Translational Research, Kidney and Pancreas Transplant Mobile Phone: (313) 282-7332 Email: MSAMANI1@hfhs.org Nadeen Khoury, M.D. Sr. Staff Transplant Nephrologist Mobile Phone: (313) 829-8315 Email: NKHOURY3@hfhs.org Anita K. Patel, M.D. Sr. Staff Transplant Nephrologist Mobile Phone: (248) 996-4661 Email: APATEL2@hfhs.org Pritika Shrivastava, M.D. Sr. Staff Transplant Nephrologist Mobile Phone: (313) 953-7393 Email: PSHRIVA1@hfhs.org

Cardiothoracic Transplant Hassan W. Nemeh, M.D. Division Head, Cardiovascular Surgery; Surgical Director, Heart and Lung Transplant Mobile Phone: (630) 886-9670 Email: HNEMEH1@hfhs.org Dimitrios Apostolou, M.D. Sr. Staff Cardiothoracic Transplant Surgeon Mobile Phone: (313) 673-7305 Email: DAPOSTO1@hfhs.org Kyle G. Miletic, M.D. Sr. Staff Surgeon Mobile Phone: (248) 417-9583 Email: KMILETI1@hfhs.org Daizo Tanaka, M.D. Sr. Staff Cardiothoracic Transplant Surgeon Mobile Phone: (313) 461-2307 Email: DTANAKA1@hfhs.org

Advanced Heart Failure/Heart Transplant & Mechanical Circulatory Support David E. Lanfear, M.D. VP, Research; Chief Scientific Officer; Senior Advanced Heart Failure and Transplant Cardiologist Mobile Phone: (248) 802-5312 Email: DLANFEA1@hfhs.org Celeste T. Williams, M.D. Medical Director, Cardiac Transplantation; Associate Director of Quality, Heart and Vascular Mobile Phone: (248) 497-6869 Email: CWILLIA6@hfhs.org

Jennifer Cowger, M.D., M.S. Medical Director, Mechanical Circulatory Support; Section Head, Advanced Heart Failure & Cardiac Transplant Mobile Phone: (734) 546-4911 Email: JCOWGER1@hfhs.org

Transplant Pulmonology

Lindsey Aurora, M.D. Sr. Staff Cardiologist Mobile Phone: (313) 920-9650 Email: LAURORA1@hfhs.org

Lisa D. Stagner, D.O. Medical Director, Pulmonary Rehabilitation Mobile Phone: (248) 765-3012 Email: LSTAGNE1@hfhs.org

Waleed K. Al-Darzi, M.D. Sr. Staff Advanced Heart Failure and Transplant Cardiologist Mobile Phone: (313) 932-3100 Email: WALDARZ1@hfhs.org Gillian Grafton, D.O. Sr. Staff Advanced Heart Failure and Transplant Cardiologist Mobile Phone: (313) 671-0277 Email: GGRAFTO1@hfhs.org Bashar Hannawi, M.D. Sr. Staff Advanced Heart Failure and Transplant Cardiologist Mobile Phone: (313) 461-2272 Email: BHANNAW1@hfhs.org Alexander T. Michaels, M.D. Sr. Staff Advanced Heart Failure and Transplant Cardiologist Mobile Phone: (313) 932-5296 Email: AICHAE2@hfhs.org Yelena Selektor, M.D. Sr. Staff Advanced Heart Failure and Transplant Cardiologist Mobile Phone: (313) 848-7257 Email: YSELEKT1@hfhs.org Cristina Tita, M.D. Sr. Staff Advanced Heart Failure and Transplant Cardiologist Mobile Phone: (313) 610-0339 Email: CTITA1@hfhs.org

Lisa L. Allenspach, M.D. Medical Director, Lung Transplant Mobile Phone: (248) 310-9746 Email: LALLENS1@hfhs.org

Domingo J. Franco-Palacios, M.D. Sr. Staff Transplant Pulmonologist Mobile Phone: (313) 623-6373 Email: DFRANCO1@hfhs.org Kaitlin M. Hanlon, D.O. Sr. Staff Transplant Pulmonologist Mobile Phone: (313) 587-6353 Email: KHANLON3@hfhs.org Julio C. Pinto Corrales, M.D. Sr. Staff Transplant Pulmonologist Mobile Phone: (313) 515-9778 Email: JPINTO1@hfhs.org

To refer a patient, please call: Liver: (313) 916-8865 Kidney and Pancreas: (313) 916-1269 Heart: (313) 916-2895 Intestine and Multivisceral: (313) 916-8865 Lung: (313) 916-1471

henryford.com/transplant | 17

Meet our newest team members

Adhnan Mohamed, M.D. Specialties: Transplant, Hepatobiliary, and General Surgery, Liver, Kidney, Pancreas, Intestine, Robotic Transplant, Hepatobiliary Surgery

Adhnan Mohamed, M.D.

Board Certifications American Board of Surgery - Surgery

Post Graduate Positions University of Virginia, Charlottesville VA

Education Wayne State University School of Medicine, MI

Multiorgan Abdominal Transplant Surgeon

Fellowship Henry Ford Hospital, MI Surgery Transplant Residencies & Internships Henry Ford Hospital, MI, General Surgery

Assistant Professor of Surgery Research Interests Dr. Mohamed’s research interests are ex-vivo machine and normothermic regional perfusion of organs; organ rehabilitation and modulation; fellow and resident education.

Languages English, Bengali, Spanish Dr. Mohamed treats patients at: Henry Ford Hospital Hospital Privileges Henry Ford Hospital Henry Ford West Bloomfield Hospital

Abbas A. Al-Kurd, M.D. Specialties: Transplant Surgery, Hepatobiliary Surgery, Surgery, Minimally-Invasive Surgery, Bariatric Surgery

Abbas A. Al-Kurd, M.D.

Education University of Jordan, Jordan

Hadassah University Hospital, Israel, Internship

Languages English, Arabic, Hebrew

Fellowship Henry Ford Hospital, MI, Transplantation and Hepatobiliary Surgery

Makassed Hospital, Jerusalem, Internship

Dr. Al-Kurd treats patients at: Henry Ford Hospital

Research Interests Dr. Al-Kurd’s research interests include the implications and effects of metabolic syndrome on the pre- and post-Transplant Surgery patient population, as well as the surgical treatment options for liver disease associated with metabolic syndrome.

Henry Ford West Bloomfield Hospital

Cleveland Clinic, OH, Minimally Invasive Surgery/Bariatric Surgery Residencies & Internships Henry Ford Hospital, MI, Surgery Hadassah University Hospital, Israel, Surgery

Hospital Privileges Henry Ford Hospital Henry Ford West Bloomfield Hospital

Ahmed Nassar, M.D. Specialties: Transplant Surgery, Surgery, Kidney Transplant, Liver Transplant, Pediatric Kidney Transplant Board Certifications American Board of Surgery - Surgery Education Cleveland Clinic, OH, Surgery Transplant Ahmed Nassar, M.D.

Alexandria University Faculty of Medicine, Egypt

Fellowship Emory University School of Medicine, GA, Surgery Transplant Residencies & Internships Cleveland Clinic Foundation, OH, Surgery

Research Interests Dr. Nassar’s research interests are in normothermic machine perfusion and hypothermic machine perfusion.

Dr. Nassar treats patients at: Henry Ford Cancer - Detroit Henry Ford Hospital Hospital Privileges Henry Ford Hospital

18 | 1-855-85-TRANSPLANT

Meet our newest team members

Lindsey Aurora, M.D. Specialties: Cardiology, Transplant Cardiology Board Certifications American Board of Internal Medicine - Cardiovascular Disease American Board of Internal Medicine - Internal Medicine Lindsey Aurora, M.D.

Education Wayne State University School of Medicine Fellowship University of Michigan, Advanced Heart Failure Henry Ford Hospital, Cardiovascular Disease

Residencies & Internships Henry Ford Hospital, Internal Medicine Research Interests Dr. Aurora has a strong interest in cardiogenic shock and inherited cardiomyopathies.

Hospital Privileges Henry Ford Hospital Henry Ford Macomb Hospital Clinton Township Henry Ford West Bloomfield Hospital

Dr. Aurora treats patients at: Henry Ford Macomb Medical Pavilion - Clinton Township Henry Ford Medical Center Sterling Heights Henry Ford Hospital

Detroit barber benefits from normothermic machine perfusion Continued from page 3

like I was a Frankenstein,” he chuckled. “I had to keep my legs straight and walk like a penguin with the heart balloon pump in me. I think I was the first patient to use the table, but it got me out of bed, and that made me feel better.”

Raleigh was unaware at the time he was the first patient at Henry Ford Hospital to receive a heart that had been perfused using the TransMedics™ OCS – Heart. His heart transplant surgeon Hassan Nemeh, M.D., surgical director of Thoracic Organ Transplant at Henry Ford Hospital, remembers well Raleigh’s very complicated condition; “he had a hard time, but the heart transplant was flawless and he did very well.”

In a very short time, Dr. Nemeh noted that Raleigh’s heart transplant was successful, and he was ready for the liver transplant. Ahmed Nassar, M.D., liver transplant surgeon at Henry Ford Hospital, transplanted the near body temperature liver that was perfused using the TransMedics™ OCS – Liver, while Raleigh was receiving his heart transplant. “Raleigh’s case was complex. While Dr. Nemeh transplanted the heart, the donated liver was being perfused and getting healthier as we waited to make sure there were no complications with the heart transplant. When the liver was placed it immediately began to function because it was near his body temperature and received the necessary oxygen and nutrition while on the pump.”

Raleigh shares that recovery from both transplants is both physical and mental. He received rehabilitation three or four times each week. “At first I could get up but had no power to move my legs, and the stairs were really hard, but it was one step at a time.” The mental part is “a little different because you wonder and want to know about the other person’s life. That person and their family gave me both a heart and a liver. For the donor’s family it’s a really sad time, but then my family and I are celebrating that I’m alive. To honor that person, I’m going to do everything to keep our heart and liver healthy.”

Henry Ford Hospital is the first transplantation center in Michigan to research and adopt organ perfusion using the TransMedics™ Organ Care Systems, which is a portable extracorporeal normothermic machine perfusion (NMP) technology for the heart, lung and liver. NMP has changed the method of preserving donated organs when harvested and transported for transplant specifically in donation after circulatory death (DCD). The organs can immediately be monitored for the lactic acid, bile production (liver), and blood flows, and medication can be administered to improve blood flow, making more organs available for transplantation.

henryford.com/transplant | 19

Phone: (313) 916-2941 Fax: (313) 916-4353

Henry Ford Transplant Henry Ford Hospital 2799 West Grand Boulevard - CFP 220 Detroit, MI 48202

Email: MABOULJ5@hfhs.org

©2024. All rights reserved.

Web: henryford.com/ transplant

For more information, please contact our outreach coordinators Michelle “Cookie” Crossley, R.N., B.S.N.

Christina Somers R.N., B.S.N.

Mobile Phone: (248) 219-2326

Mobile Phone: (313) 622-4352

Email: MCROSSL1@hfhs.org

Email: CSOMERS1@hfhs.org

On call 24/7 Read and share Henry Ford Health Transplant Notes online. https://issuu.com/hfhealth

Katie Dandron, R.N. Mobile Phone: (313) 353-3990 Email: KDANDRO1@hfhs.org