Jennifer Golden, lung-liver transplant recipient

UCLA Surgeons Perform First
Double-Lung-Liver Transplant

Surgeons at Ronald Reagan UCLA Medical Center performed
the first double-lung-liver transplant on December 4, 2011.

The recipient, Jennifer Golden, a 19-year-old college student from Las Vegas, has a genetic condition called cystic fibrosis, which produces thick, sticky mucus in her lungs that traps infection-causing bacteria. As a result, Golden experienced shortness of breath, excess mucus, coughing, an inability to gain weight and diabetes.

Golden’s disease required her to have routine “tune ups” to clear the mucus in her lungs with antibiotics, intravenous medications, physical therapy and other procedures. Over the years, however, her lungs developed infections that became increasingly difficult to treat. To make matters more complicated, Golden’s liver function was also affected by the disease. At age 17, she was so sick she could no longer attend high school. Her lungs and liver were simultaneously deteriorating, and she was told her only chance at life was organ transplantation.

Even single-lung-liver transplant surgery is rare. According to the most current data available from the United Network for Organ Sharing, which manages the country’s organ donation system, only 46 lung-liver transplants have been performed in the United States. It is also unusual for a cystic fibrosis patient to need both lungs and a liver. More commonly, because of the way the disease progresses, the patient needs only one organ or the other.

“Because of her small size and the necessity for both the lungs and liver to be usable, she knew — as did we — that her wait might be long,” says Sue McDiarmid, M.D., director of the Pediatric Liver Transplant Program and Golden’s doctor for 10 years.

Meanwhile, Golden’s entire lung and liver transplant team — including surgeons, physicians and anesthesiologists — spent time planning for her complex surgery. For example, the surgeons decided that the best approach would be for the lung transplant to be performed first.

“We also consulted with reconstructive surgeons to map out where we would make our incisions so that Jennifer’s abdominal muscles, bone and skin would not be impacted,” notes Doug Farmer, M.D., surgical director of the Pediatric Liver Transplant Program. “Our goal was to perform the surgery efficiently and with minimal blood loss.”

Two years later, on Saturday, Dec. 3, Golden got the call that a donor had been found. She and her mom quickly flew to UCLA while her dad followed behind in the family car. Jennifer was wheeled into surgery around 4:45 a.m. on Dec. 4. The team’s intense planning paid off, and the 13-hour operation went smoothly.

When Golden came out of surgery, her ability to breathe was immediately improved. With the diseased lungs removed, her illness is now gone, although her cystic fibrosis is not technically cured since it is part of her genes.

“We are quite optimistic that Jennifer will do well,” says Abbas Ardehali, M.D., surgical director of the UCLA Heart and Lung Transplant Program. “Our mission at UCLA is to expand the horizon of transplant patients we can serve.”

The former high-school tennis team captain can now look to the future. Her plans include being with her fiancé, continuing her college studies and hitting the tennis courts again.

“I hope that if a family out there is ever suffering with the death of loved one, they will consider the priceless gift of organ donation,” Golden says. “Someone did that for me, and it saved my life. My family and I cannot thank them enough.”

To watch a video of Golden, visit: transplants.ucla.edu/lung