Patient with Rare Condition is Now Disease Free Following Dual-Organ Transplant & Stem Cell Transplant
David Gildea believes that if physicians at The Nebraska Medical Center hadn't been willing to take a chance on him, he wouldn't be here today.
"I knew my odds of surviving amyloidosis were very slim," said Gildea. "I am so thankful that the medical center was not afraid to roll the dice." Gildea is among few patients with amyloidosis to receive a dual-organ transplant followed by stem cell transplantation.
"All of the transplants have been successful," said Eugenia Raichlin, MD, cardiologist at The Nebraska Medical Center. "David is doing well and we have seen very little complications."
Amyloidosis is a rare blood disease affecting only eight of every one million people. People who have the disease have abnormal protein deposits of amyloid (pronounced AM'-i-loyd) in their tissue or organs. The disease is rapidly disabling and life-threatening. Harm results when the deposits cause the organs to malfunction. In Gildea's case, his heart and kidneys were affected.
His treatment required highly specialized expertise from several different medical specialties.
First Step in Treatment: Dual Organ Transplant
The innovative treatment began on May 18, 2010 - Gildea was the first patient at The Nebraska Medical Center to receive a combined heart and kidney transplant.
"Before the heart and kidney transplant, Gildea was as sick as a person can get," said Clifford Miles, MD, co-director of the kidney/pancreas transplant program at The Nebraska Medical Center. "David had end-stage heart disease. His kidneys were also barely functioning, requiring daily dialysis."
Gildea recalls that he had very little endurance and stamina before his heart and kidney transplant. "I had a hard time doing anything. It would take me a few hours to get dressed every morning."
"He was exhausted just walking from the bedroom to the living room," said Gildea's girlfriend, Karen Rech.
Immediately following the dual organ transplant, Gildea said he felt like a new person. "I wasn't short of breath when I went for a walk."
Second Step in Treatment: Stem Cell Transplant
Although Gildea's heart and kidney transplant gave him new strength, he still had the rare blood disease, and without the removal of the amyloids from his blood stem cells, his new organs would likely fail again.
Edward Faber Jr., DO, MS, hematopoietic stem cell transplant specialist at The Nebraska Medical Center prepared Gildea for four months for his next step of treatment - an autologous blood stem cell transplant.
An autologous stem cell transplant is a procedure in which blood-forming stem cells are removed, stored, and later given back to the same person. Gildea had four bags of his stem cells collected and stored in liquid nitrogen. He then received high-dose chemotherapy for two days to damage the blood stem cells which were causing the amyloidosis. After chemotherapy, on Sept. 10, 2010, Gildea's stored blood stem cells were reintroduced into his body to replace the damaged blood cells.
Three months later, on Dec. 22, 2010, Gildea heard the news he had been waiting to hear - that he is disease free. The stem cell transplant was successful in killing the amyloids in blood stem cells.
Dr. Faber says the one year anniversary after the stem cell transplant will be the most important date.
"If the amyloids don't reappear for one year after the stem cell transplant, the chance of the amyloids staying absent for the next five years is about 70 to 80 percent," said Dr. Faber.
"The news that I am 'amyloid-free' was a great way to start the New Year," said Gildea. "It gives me a reason to keep working out every day and getting stronger."