Mayo Clinic marks 60 years since first organ transplant

Kurt Brandau holds the rhythm of music in his hands.

The sticks bouncing off the heads of his drum kit pound out a beat in metronomic time. It’s no small feat that the precision of the beat pouring from his hands is made possible by the precision of the beat in his heart — a new heart.

"I was born with a congenital aortic stenosis," said Brandau of the condition that narrowed the aortic valve in his heart.

To help his heart function better, doctors implanted a mechanical valve when he was a young child. He got another mechanical valve when he turned 15-years-old.

Then, another one 27 years later.

But after five surgeries, his doctors told him his heart could take no more.

"They had said, you know, we just don’t really see you getting out of this without a heart transplant," said Brandau of the conversation with Mayo Clinic cardiologists in Jacksonville, Florida in 2015. "It was very complex, and they didn’t think it was something that they could do down there, so they suggested that I come to the Rochester Mayo."

Brandau’s journey to what would become a successful heart transplant at Mayo Clinic in Rochester actually began 60 years ago this week.

On Nov. 25, 1963, a surgical team led by Dr. George Hallenbeck performed Mayo’s first human organ transplant. It was a kidney. 

Since then, Mayo has built on the success of that first surgery and now has 31,568 organ transplants in the books as of Oct. 31. The vast majority are kidneys, but they’ve also transplanted more than 10,000 livers, 2,081 hearts, and 1,318 lungs. Between the three Mayo Clinics in Minnesota, Arizona and Florida, it now transplants more organs than any other transplant program in the United States.

"For us, it’s opportunity to look on the progress that we have made since that first transplant until now," said Dr. Julie Heimbach, a surgeon and director of the Mayo Clinic transplant program. "When I looked at how things went with the very first few transplants, the most amazing thing was that it was even possible."

Heimbach said doctors were challenged in the beginning as they learned this new but promising field of medicine.

In the first few years, Heimbach said the survival rate of patients receiving transplanted organs was less than 50% after one year. Now, it’s more than 95%.

"So, the major change is being able to use medications to allow the immune system not to fight with the new organ, to not have rejection," Heimbach said.
Technology has changed, too.

Earlier this month, Heimbach was on the team of Mayo doctors who for the first time transplanted a kidney with the use of a robotic machine called a da Vinci Surgical System.

The machine consists of three robotic arms that enter the human body through very small incisions. Using a control device just a few feet away from the patient, the lead surgeon can manipulate the three mechanical arms to triangulate to precise spots to perform the intricate sutures to connect the new kidney.

"Particularly for patients who had previous incisions in the lower part of their abdomen, or have a little bit heavier body size, this can really help them recover in a more streamlined way and get back to having good function earlier," explained Dr. Heimbach about the benefits the robotic surgery.

But with the advancements in transplant procedure and medicine, the main challenge is still resolving the extreme mismatch between patients who need a new organ and the availability of one.  As of Nov. 23, the Organ Procurement and Transplant Network and the U.S. Department of Health and Human Services report 2,462

Minnesotans are on the waiting list for an organ transplant.

The majority, 1,893 of them, are waiting for a kidney, another 165 are waiting for a liver, and 98 are waiting for a heart.

The advancements in recent years of paired-chain kidney donations have helped more people receive a perfectly matched organ.

In the case of a person who wants to donate a kidney to a loved one but may not be a perfect match, they can donate their kidney to someone they do match with.

In return, someone else donates their kidney to the original donor’s loved one. Mayo Clinic has participated in multiple paired match donations.

With heart and lungs, surgeons have been able to use new technologies with perfusion to use more donated organs than they have in the past. 

"These are technologies that allow us to assess the organ and make sure that it would be safe to transplant and make it function a little bit longer and a little better," said Heimbach while explaining that it would allow them to perform more heart and lung transplants.

There is also the possibility of growing organs.

Mayo Clinic is currently collaborating with a Twin Cities biotech firm to construct new livers from human cells in a process called bioengineering. In the lab, scientists create a scaffold of tissue in which they add human cells to build a kidney or liver.

"All of these things are ongoing, using cellular therapies to either regenerate organs that we would then want to transplant or keep the organs that we’ve transplanted living longer or doing better over the long term," explained Heimbach.

Some patients must rely on multiple transplants.

Among them is Kurt Brandau. One of the side of effects of his failing heart was kidney damage.

While recovering from his heart transplant on Nov. 3, 2022, it became quickly clear that he would need a kidney transplant as well.

On the anniversary of receiving his heart, Brandau learned that there was a match for a donated kidney. His kidney transplant surgery was also performed at Mayo Clinic, and it too was a success.

"I feel great," said Brandau from the kitchen table at his home in Bryon, Minnesota. "I have way more energy than I’ve had in a long time."

Both Brandau and his wife Jessica are the first to acknowledge that his positive outcomes are all because of the extreme generosity of other individuals and their families who committed to organ donation.

For those who have not made the decision to sign the Minnesota driver’s license to become an organ donor, the process can get started through LifeSource.

LifeSource is the non-profit organization designated by the federal government to manage the procurement and distribution of donated organs in Minnesota, the Dakotas and northwestern Wisconsin.

"I can now say that, God willing, I have more life to live because of somebody’s gift of life to me," said Brandau.