At holiday dinners this year, Calabasas, Calif., resident Jim Stavis, 52, was able to eat the same pumpkin pie and special desserts everyone else had, not the sugar-free variety. And when dinner was over, he didn't have to reach for his insulin pump to try to compensate. A pancreas transplant performed at Cedars-Sinai Medical Center in late October cured him of diabetes, which had controlled his life for 35 years.
Oh, and a heart and kidney transplant performed at the same place and same time the year before saved his life.
Only about eight patients in the United States have received simultaneous transplants of a heart, kidney and pancreas since 1992, according to the Organ Procurement and Transplantation Network (OPTN), and the first European patient to receive this combination of organs simultaneously was reported to be in good health 11 years after the procedure. If a combination like Jim's - heart and kidney, followed later by a pancreas transplant - has been performed, it does not appear to be documented in medical literature. In any case, Jim is among elite company worldwide.
Jim was diagnosed with diabetes when he was 17. "I was told, back in the early '70s, that having diabetes meant a life of potential amputations, blindness, kidney disease and other problems.
He decided to adopt a positive outlook, managing his health as best he could, and accepting life and its challenges as they came. He remained relatively healthy for about 20 years but began to encounter diabetes-related complications - such as a blocked coronary artery - in the late 1990s. Under the care of cardiologist P.K. Shah, M.D., director of Cedars-Sinai's Division of Cardiology and the Atherosclerosis Research Center, Jim was able to manage his heart problems conservatively until more serious problems emerged.
"In the winter of 2004, we went to visit my daughter at her college in Madison, Wisconsin for Parents' Weekend and my kidneys shut down and I went into congestive heart failure," Jim says. "That was a big signal that I needed to do something."
After more than a week in a hospital in Madison, he came home and saw Shah, who said he would need a heart and kidney transplant, followed by a pancreas transplant.
"He described the heart and the kidneys as the targets of diabetes, and the pancreas as the trigger. Just addressing the target, without eliminating the trigger, would have created a situation that could jeopardize the new organs," Jim recalls.
The first transplants were performed in November 2005. J. Louis Cohen, M.D., surgical director of Kidney Transplantation and medical director of Operating Room Services, headed the kidney transplant team. Alfredo Trento, M.D., chair of the Division of Cardiothoracic Surgery performed the heart transplant, and Lawrence S.C. Czer, medical director of the Heart Transplant Program and director of Transplantation Cardiology, served as Jim's primary cardiologist.
Two specialists joining Cedars-Sinai, one in 2005 and one in 2006, also became members of Jim's medical team: cardiologist Ernst R. Schwarz, M.D., Ph.D., who specializes in several aspects of cardiology, including cardiac transplantation; and Donald C. Dafoe, M.D., director of Pancreas Transplantation.
Pancreas transplantation is a relatively new development in the field. It is fairly uncommon and usually performed only in conjunction with a kidney transplant. Dafoe is one of the nation's leading pancreas transplant surgeons.
Jim's operations and recoveries have gone so well that he expects to be golfing and working out by January. Since November, he has returned to work two or three days a week.
"When Dr. Dafoe came out of surgery to talk to my family and friends in the waiting area, he said, 'I'm happy to report that Jim Stavis is no longer a diabetic,'" says the owner of a metal fabricating and distributing company in Long Beach. "That in itself is quite a statement. When I was a teenager, I hoped there would someday be a cure for diabetes, but I never thought my cure would happen this way. Back then, we never imagined that pancreas transplants were possible."
Some aspects of instantly becoming a non-diabetic have taken some adjustment while others have not, Jim says. It seems strange to be permitted to eat normally and enjoy traditional pumpkin pie after 35 years. But it was easy to give up the inconvenience that goes along with managing diabetes.
"I used to have an insulin pump, so when I would eat I would have to manually put in how much insulin I needed to take after a meal," he says. "People have asked me, 'Isn't it weird to suddenly be able to eat and not reach for the pump?' And the reality is that habit was broken in about a minute. I never for a moment looked back."