Double the Teamwork

The odds were stacked against Kelly Anspaugh since he was diagnosed with heart failure in 2001.

He received an implanted defibrillator, which kept him alive, but his health kept declining. One day in 2014, Kelly’s wife came home to find him collapsed in the living room. At the hospital, they learned that all afternoon, he technically had been dying. His heart had stopped repeatedly, but the defibrillator continually restarted it.

After that incident, Kelly and his wife realized he needed more advanced care. 

The Sedalia couple turned to Saint Luke’s Mid America Heart Institute, home to one of the nation’s top cardiac programs.

Kelly met with cardiologist Andrew Kao, MD, who started him on new medication and coached him to lose weight. Kelly also received a left ventricular assist device (LVAD), a heart pump that would take over for the left side of his heart. The LVAD helped, but over the next few years, Kelly’s overall cardiac function continued to decrease. 

The stark reality was that he needed a new heart, but he didn’t meet the medical criteria for a transplant. He was overweight, and a 2018 prostate cancer diagnosis was another setback.

Transplant eligible 

Kelly refused to give up. He worked to lose weight, and successfully underwent treatment for his cancer. By April 2022, though, the 61-year-old was back in the hospital, sicker than ever.

“It got to where I just couldn’t breathe,” he said. 

At that point, Kelly met the criteria for a heart transplant.

“He was reasonably young and in reasonably good shape,” said Jessica Heimes, MD, the heart surgeon who eventually performed Kelly’s heart transplant. “And he had a great attitude. He had overcome all the challenges we gave him.”

However, his ongoing health problems had taken a toll. Now, he needed not only a heart, but also a new kidney. Patients who need multiple organs ideally receive them from the same donor. Kelly’s heart was failing fast, and the chances of him getting both organs in time were small.”

"It’s beyond a Hail Mary at that point,” said Dr. Kao. “I sat down at his bedside and said, ‘Kelly, we are as backed up against a wall as we can be.’”

“When I found that out, it was depressing,” Kelly said. “I told my wife, ‘There’s no way I’m going to get both.’” 

Not wanting to die in the hospital, he prepared to go home to live out his final days. “I didn’t know how long I would last,” Kelly said, “but I had made peace with it.”

But Kelly’s doctors saw one other option. They could put him on a second heart pump, a right ventricular assist device (RVAD), while he waited. While Kelly’s LVAD, the pump for his heart’s left side, could be used long-term, the RVAD was far more complicated. Such pumps typically work only seven to 10 days before the body begins to have problems—meaning time was short to find a donor. 

When Kelly heard the idea, though, he didn’t hesitate. 

“He trusted us,” said Dr. Kao. “Kelly told me, ‘Let’s try it. Your team has been with me the whole time and you’ve always done what is right’."

Getting the call 

Kelly’s luck was about to change. After 11 days on the RVAD—the outer limit— both a heart and kidney became available. 

“When the call came, all of us just cried,” said Dr. Kao. Because the heart is more time-sensitive, Dr. Heimes went first. 

Next, the critical care team had to determine when Kelly would be stable enough for the kidney surgery. It typically takes several hours, but every patient is different, explained Matthew Wilkinson, MD, who performed Kelly’s kidney transplant. 

“If there are problems with the heart, then we can’t go right away, but you don’t want to wait too long,” Dr. Wilkinson said. “Finding that balance is more of an art than a science.” 

Fortunately, transplanting the new heart went seamlessly and Kelly bounced back quickly. He received his kidney, also with no problems. 

He spent several weeks in rehabilitation and now marvels at doing everyday activities like fishing, and even climbing stairs. 

“I feel like I’m 35,” he said. 

Although Saint Luke’s has performed almost 1,000 heart transplantations in its 38-year history, only about 25 of those have entailed a double transplantation with another organ. Such procedures pose both medical and logistical challenges, requiring flawless coordination between the surgical teams. 

“Fortunately, we work in a really strong, collaborative environment, and that’s a big testament to why we’re successful,” said Dr. Wilkinson. “Kelly is a textbook case of what we do well at Saint Luke’s.”