Combined Kidney/Pancreas Transplant Recipient Exceeds Age Limits
After living with type 1 diabetes for more than three decades, Mark Mastroianni knew the ins and outs of life with a chronic disease. But he still wasn’t prepared for the news his nephrologist gave him in early 2015.
“He told me I had about 17 percent of my kidney function. It was a pretty traumatic experience for my wife and me to hear I was that sick,” says Mastroianni, who lives in O’Fallon, Missouri.
Type 1 diabetes is a chronic condition in which the pancreas produces little to no insulin, which the body needs to convert glucose, or sugar, into energy. The condition is typically diagnosed in childhood.
Mastroianni’s nephrologist, Daniel Young, MD, kidney specialist at Barnes-Jewish St. Peters Hospital, says one of Mastroianni’s options was dialysis. Though dialysis would have functioned in place of Mastroianni’s kidneys, eliminating waste and water from his blood, Dr. Young knew it would be not only a temporary solution but also a risky one because of Mastroianni’s diabetes.
What he really needed was a combined kidney/pancreas transplant, which can treat both type 1 diabetes and kidney failure. But Mastroianni was 60 years old, significantly older than most good candidates for this combination transplant. Dr. Young referred Mastroianni to Jason Wellen, MD, surgical director of the combined kidney/pancreas program at the Washington University and Barnes-Jewish Transplant Center.
“When we started performing kidney/pancreas transplants, we didn’t attempt the procedure on patients older than 50. It was just too risky,” says Dr. Wellen. “But as our knowledge and experience have increased, so has our ability to adjust the age limit. Mr. Mastroianni had taken great care of himself despite his health challenges. And he passed the rigorous testing required to become a candidate for transplant.”
About 20 combination kidney/pancreas transplants are performed at the Washington University and Barnes-Jewish Transplant Center each year, making it one of the biggest centers of its kind in the United States. Nationwide, about 400 people receive a combined kidney/pancreas transplant each year, and outcomes at Barnes-Jewish Hospital consistently exceed national averages.
Because Mastroianni was a good candidate despite his age, he was approved for transplant and his name was placed on a waiting list managed by the United Network for Organ Sharing (UNOS). UNOS considers many factors, such as the patient’s geographic location, blood type and illness severity, to determine a patient’s placement on the waiting list.
In Mastroianni’s case, however, the process moved quickly, and he was matched with a donor in July 2015. Dr. Wellen and his team performed a successful operation, making Mastroianni the oldest patient to receive a combined kidney/pancreas transplant through Barnes-Jewish Hospital’s program.
“Since the procedure, he hasn’t needed a drop of insulin, which is an ideal outcome,” Wellen says.
It didn’t take Mastroianni long to feel good again. Just four months after his operation, he finished a 10K race at a 10-minute-per-mile pace. Though he was an avid runner even before his transplant, back then he was “barely cracking a 16-minute mile,” making his post-transplant 10K time all the more impressive.
“My youngest son is a runner too, and now he’s worried I might just catch up to him. I really have been born again,” Mastroianni says.
He describes himself as full of energy and credits his combination transplant with changing his life.
“All of the doctors, nurses and coordinators who took care of me were just great,” Mastroianni says. “I knew Barnes-Jewish was a good hospital, but I didn’t realize just how good it is. I’ve put Dr. Wellen and his team on a pedestal.”
Mastroianni says he is thankful not only for the care he received at Barnes-Jewish but also for the organ donor who gave him a better life.
“I wish I had been an active proponent of organ donation prior to my surgery,” he says. “My life was saved thanks to the skill of the transplant team and the decision someone made to be an organ donor.”
For more information on the kidney/pancreas transplant program, call 314-867-3627 or 866-867-3627 (toll free).
To learn more about organ and tissue donation or to register to be a donor in your state, visit organdonor.gov.