Josiah Ferrell, a 25-year-old cystic fibrosis patient, received a dual lung and liver transplant and is the first patient to undergo the procedure in North Texas.

The procedure was performed by transplant surgeons Dr Michael Wait, chief of the Cardiovascular and Thoracic Surgery Service at William P. Clements Jr. University Hospital, who performed the lung transplant, and Dr Malcolm MacConmara, also trained in immunology, who performed the liver transplant. Overall, the transplant surgery lasted 12 hours and involved more than a dozen physicians and other team members, organized in two teams — one to remove and replace the lungs, and a second to remove and replace the liver.

The team of experts, in order to minimize the time between organ removal and transplant, decided to remove one lung, complete the transplant, and then perform the removal of the second lung and subsequent transplantation, a strategy that allowed the surgeons to avoid having the patient on a heart-lung bypass machine. The abdominal team was then able to perform the liver transplant, using a piggyback technique that leaves in place an important vein that returns blood from the abdominal organs to the heart, helping stabilize the patient.

“The lungs were implanted without much of the difficulty we had anticipated and planned for, and the transition from lung to liver transplant was seamless,” Wait said in a news release.

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