Former Miller School Surgical Fellow Performs Haiti’s First Organ Transplant with Assistance from UM

Jacques Juedy, M.D., served as a surgical fellow at the Miami Transplant Institute at UM/Jackson

Haiti’s only transplant surgeon and Miller School transplant specialists gave Haiti’s former minister of health an extraordinary birthday gift – and thousands of dialysis patients on the island a glimmer of hope – by making the popular doctor the first recipient of a solid organ transplant in his impoverished nation.

For obstetrician Jean Boisrond, M.D., who lost his sight and mobility as his end-stage renal disease worsened, the Nov. 30 kidney transplant arranged and performed by Haiti’s Jacques Juedy, M.D., with assistance from Miller School surgeons George W. Burke, M.D., and Gaetano Ciancio, M.D., and anesthesiologist Ernesto Pretto, Jr., M.D., was literally a life-saver.

“Last Wednesday was Dr. Boisrond’s birthday – he turned 63 – but really it was his rebirth,” said Jeudy, who founded his homeland’s transplant program in 2008 after serving as a surgical fellow under Drs. Burke and Ciancio at The Miami Transplant Institute at UM/Jackson. “If he didn’t get the transplant, he would have died.”

Today, Boisrond, who received a kidney from his 32-year-old niece, is walking the halls of the Centre Hospitalier du Sacre Coeur in a suburb of Port-Au-Prince, cracking jokes and expressing his gratitude to the Haiti Kidney Transplant Program, and the Miller School physicians and fellow team members who donated their time and services.

“I am very grateful to the team from the University of Miami,” Boisrond said in a phone interview through a translator. “They were very efficient and very formidable in their intervention. I owe them a great deal – my life.”

The successful 11-hour surgery marked the official birth of Haiti’s fledgling transplant program, which Jeudy has dreamed of starting for the past 15 years. Already, at least 14 other dialysis patients with matched donors have signed up for kidney transplants and a second surgery is slated for January.

“This is the beginning,” Jeudy said in a phone interview from Haiti. “It is the first step of a long journey.”

It is, though, a journey neither Jeudy nor Haiti can embark on alone. Both need the continued support, assistance, resources and expertise of Miller School specialists, who are committed to helping the Western Hemisphere’s poorest nation develop the complex transplant infrastructure it lacks.

“This is not a one-shot deal,” said Pretto, professor of anesthesiology and chief of the Division of Solid Organ Transplant. “We’re going to build on this. We’re going to enter in a partnership with Dr. Jeudy to help him develop a transplant infrastructure in Haiti, which includes legislation to develop the proper organizations. Right now they don’t have anything but human resources such as Dr. Jeudy, who is an excellent surgeon. They need organ procurement and sharing organizations. They need brain-death laws. It’s a process, and this was the kick-off for the process.”

Haiti will need more surgeons as well as critical care nurses, transplant coordinators and others skilled in complex transplants, some of whom began their training by crowding into the operating room in the small, private hospital to observe the top-notch team Jeudy assembled to perform Haiti’s history-making transplant.

Pretto guided the hospital’s very able anesthesia team, while Ciancio, professor of surgery and urology, performed the live donor operation; Jeudy performed the transplant, with the assistance of Burke, professor of surgery and director of Kidney and Pancreas Transplantation. Also assisting were Jackson nurse coordinator Magalie Martial-Paul, R.N., and critical care nurses Erick Mendieta, R.N., and his wife, Tara Mendieta, R.N., a student in UM’s acute care nurse practitioner program.

For Erick Mendieta, who helped Burke with supplies and cared for the donor and recipient after their surgeries, the operation held multiple special meanings. Born with bilateral hydronephrosis, Mendieta, now 36, spent much of his first 30 years in and out of hospitals fighting to stay alive. Today, he is healthy, thanks to a kidney donated by his brother and transplanted by Burke, with Ciancio’s assistance, in 2005.

Soon after his operation, Mendieta began working in the surgical ICU at Jackson where he cared for transplant patients. It was there that he met the humble and dedicated doctor from Haiti who was on a mission for his country.

“When I met Dr. Jeudy at Jackson he told me he was working toward Haiti’s first transplant,” recalled Mendieta, who left Jackson last year to return to school to become a nurse anesthetist. “Since I was a transplant patient working with transplant patients he asked if I would be on his team but, honestly, I had forgotten about it until the call came.”

Mendieta said he got goose bumps when Jeudy asked if he’d still be on the team.

“Here I am someone who was very sick but lucky enough to have a brother willing to give me a kidney and access to the best transplant doctors,” Mendieta said. “Then I have the opportunity to work with my doctor to help someone in a country with few resources get a second chance like I had. It was amazing.”

Second chances, though, remain extraordinarily rare in Haiti. Jeudy said more than 7,000 Haitians are afflicted with end-stage renal disease but, with only three dialysis centers on the island, many cannot get to, much less afford, the life-sustaining treatment.

“It costs 2,400 U.S. dollars a month for dialysis and there are not enough machines, so people are dying one right after the other,” he said. “It is terrible. The only reason why I am here is to help those people get a second chance in life. The only reason.”

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