March 1, 2018/Digestive

Cleveland Clinic Abu Dhabi Establishes UAE’s First Comprehensive Organ Transplant Program

Completed full liver and lung transplants in 2018, following earlier heart and kidney transplants

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Physicians at Cleveland Clinic Abu Dhabi have created history in the UAE by developing a comprehensive multi-organ transplant program which is already transforming patients’ lives.

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This month, the multispecialty hospital successfully completed the United Arab Emirates’ first full liver transplant and first lung transplant, both from deceased donors.

Following the pioneering surgeries, which took place on Feb. 1 and Feb. 11, Cleveland Clinic Abu Dhabi has now performed deceased donor transplants for four major organs – kidney, heart, liver and lung.

The UAE’s first full liver transplant, which took place on February 1, was performed by a five-person medical and surgical team led by Antonio Pinna, MD, transplant surgeon at Cleveland Clinic Abu Dhabi. The UAE’s first deceased donor lung transplant, which took place on Feb. 11, was led by Redha Souilamas, MD, Chief of Thoracic Surgery at Cleveland Clinic Abu Dhabi.

Doctors at a conference

Cleveland Clinic Abu Dhabi is the first and only multi-organ transplant facility in the UAE.

In December 2017, surgeons at Cleveland Clinic Abu Dhabi performed the UAE’s first full heart transplant, while a team from the hospital successfully conducted one of the UAE’s first kidney transplants from a deceased donor in September 2017.

Cleveland Clinic Abu Dhabi is currently the UAE’s first and only multi-organ transplant facility, following the UAE government decree last year allowing deceased donor transplants.

Sheikh Abdullah bin Mohammed Al Hamed, Chairman of the Department of Health, says: “We are immensely proud to achieve these new medical milestones in the UAE. Coming only weeks after Cleveland Clinic Abu Dhabi completed the UAE’s first full heart transplant, this progress shows just how far the UAE has come in providing advanced medical services which enable patients to receive the very best care at home.”

“Our next step has to be supporting a robust culture of organ donation to make it easy for people to gift their organs. We are seeing the incredible impact that organ donation is having on multiple lives within the UAE, and are receiving regular inquiries from people looking to donate, so will work with our partners to make the process easier and more accessible,” he adds.

The operations were supported by the Ministry of Health.

Cleveland Clinic Abu Dhabi, part of Mubadala’s network of healthcare providers, has worked closely with the Cleveland Clinic Transplant Center in the U.S., a world leader in organ transplantation; partner hospitals in the UAE; and the Saudi Center for Organ Transplant in establishing its organ transplant program. The transplant program has also benefitted from continued collaboration with Abu Dhabi Police and a number of other government entities. By cooperating with multiple facilities across the region, experts are optimistic that a wider pool of potential donors can be engaged and transplants can be conducted more rapidly for the seriously ill.

Waleed Al Mokarrab Al Muhairi, Chairman of Cleveland Clinic Abu Dhabi, Mubadala’s Deputy Group CEO, and Chief Executive Officer, Alternative Investments & Infrastructure, says: “These historic surgeries are the product of ongoing and established cooperation between a number of UAE, regional and global entities. They involved physicians from Abu Dhabi, Ajman and Fujairah as well as transportation from the National Transplant Committee and liaison and expert advice from Cleveland Clinic Transplant Center in the United States.”

Ali Abdul Kareem Al Obaidli, MD, Chair of the National Transplant Committee, says: “There is growing public support for organ donation in the UAE, and this is not surprising because the UAE has a historic culture of donation in general. We are currently working on plans to extend this effort further through a community outreach program. Already, we have been contacted by many people who have expressed an interest in donating their organs after they die and we would like to open a UAE donor registry to the public in the near future.”

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“We are very proud that Cleveland Clinic Abu Dhabi is the first and only multi-organ transplant facility in the country,” says Rakesh Suri, MD, D Phil, CEO of Cleveland Clinic Abu Dhabi. “The hospital is pleased to be able to repay just a small amount of the trust placed in us by the people of Abu Dhabi by ensuring that some of the sickest patients we treat are now able to receive cutting edge surgical and medical treatment without traveling abroad.”

Liver Transplant:

A five-person medical and surgical team performed the UAE’s first full liver transplant, which took place on Feb. 1. The team included: Dr. Pinna, transplant surgeon; Yasir Akmal, MBBCh​, hepatobiliary surgeon; Naveed Ahmed, MD, hepatobiliary surgeon; Ahmad Matalkah, MD, clinical associate; and Shiva Kumar, MD, Chief of Gastroenterology & Hepatology – all of Cleveland Clinic Abu Dhabi.

The patient, a 60-year-old Emirati man, had been suffering from cirrhosis with liver failure complicated by ascites and peritonitis. He had also suffered gastrointestinal bleeding due to underlying cirrhosis, that underscored the urgent need for a liver transplant.

To complete the operation, the surgical team used an innovative technique, preserving the patient’s own vena cava to reduce blood loss. The complex eight-hour surgery involved a wider medical team comprising more than 30 surgical and medical staff, including nurses, anesthesiologists, intensivists, technicians and many others.

Three surgeons and two nurses from Cleveland Clinic Abu Dhabi travelled to Sheikh Khalifa Medical City – Ajman to retrieve the donor liver and other organs before rushing back to Abu Dhabi via an air ambulance supplied by the UAE National Transplant Committee to perform the eight-hour transplant surgery.

Dr. Pinna, who has conducted more than 1,200 liver transplant surgeries, says: “This surgery was a tremendous achievement for Cleveland Clinic Abu Dhabi and the UAE as a whole. I personally would like to thank the entire team for making this operation a success. Liver transplantation is a very complex procedure and the surgery itself is only part of the story – there is a whole team who works on the preparation, management of the operation, transportation of the organ and the long-term treatment of the patient. This multidisciplinary approach will provide the foundation for the UAE’s transplant program.”

Adds Dr. Kumar: “This milestone is the culmination of more than two years of meticulous planning by our multidisciplinary liver transplant team. We are pleased to report that, after months of deteriorating health, the patient is recovering well and will be back home soon – which would not have been possible without the transplant.”

At the same time, surgeons from Cleveland Clinic Abu Dhabi also transplanted a kidney from the same donor to another patient at the hospital while a second kidney was transplanted to a patient at Sheikh Khalifa Medical City in Abu Dhabi. Other organs were used by surgical teams in Saudi Arabia.

Lung Transplant:

The UAE’s first deceased donor lung transplant, which took place on Feb. 11, was led by Dr. Souilamas, who led a team of 15 people in the operating room.

Gurjyot Bajwa, MD, a cardiac surgeon in Cleveland Clinic Abu Dhabi’s Heart & Vascular Institute, flew to a hospital in Fujairah to assess the condition of the donor lungs before transporting them back to the hospital via air ambulance, again supplied by the National Transplant Committee.

The lung transplant patient, a 53-year old UAE national, had been suffering from chronic obstructive pulmonary disease and had been on Cleveland Clinic Abu Dhabi’s transplant waiting list for three months after he was referred to the hospital from Dubai.

After two and a half years of training, the team was able to transplant the patient’s right lung in a surgery which lasted just three hours and 20 minutes using a minimally-invasive approach.

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Dr. Souilamas, who has personally completed more than 130 double lung transplants during his nearly 30-year career, says: “Lung transplants are traditionally higher risk than many other types of organ transplants, due to the high possibility of infection. In this particular case, we had to work especially quickly due to the fact that both the donor and the recipient were over 50 years old, which can increase surgical risk. It is testimony to the dedication of the preparation of the entire team that, on the day when we were finally able to perform the surgery, everything went very smoothly and we completed the operation very swiftly.”

Heart Transplant:

On the evening of Dec. 5 and into the early hours of the following morning, the UAE’s first full heart transplant was performed by a four-person surgical team that included Dr. Suri; Dr. Johannes Bonatti, MD, Chief of the Heart & Vascular Institute; Stefan Sanger, MD, clinical associate; and Jehad Al Ramahi, MBBS, clinical associate – all of Cleveland Clinic Abu Dhabi.

The patient, a 38-year-old Emirati man, had been suffering from end-stage heart failure and was managed by the Heart Failure and Transplant Program for almost six months. The patient is currently recovering well and has been discharged from the hospital, although he continues to attend follow-up visits.

On the same night, Bashir Sankari, MD, Chief of the Surgical Subspecialties Institute at Cleveland Clinic Abu Dhabi, performed a kidney transplant from the same donor, providing vital surgery for another patient on the hospital’s transplant list.

Kidney Transplant:

In September 2017, physicians at Cleveland Clinic Abu Dhabi, performed the hospital’s first deceased donor kidney transplant, one of the first deceased donor kidney transplants in the UAE.

The recipient, a 40-year-old female Emirati, had been suffering from kidney failure for nine years, which was caused by hypertension.

The kidney was transferred to Cleveland Clinic Abu Dhabi over a 7.5-hour journey from the deceased donor’s hospital.

Dr. Sankari, who has performed more than 1,000 kidney transplants during his career, led the surgery.

The patient had only just arrived in Jeddah, Saudi Arabia, for a short visit when she received a call from Cleveland Clinic Abu Dhabi’s transplant team that a deceased kidney donor had been found.

Intensive Care Units:

All transplant patients are immediately transferred to the care of Cleveland Clinic Abu Dhabi’s ICU under the care of Fadi Hamed, MD, Critical Care Physician at Cleveland Clinic Abu Dhabi.

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