Molly Sager Harvell – Kidney Robotic Autotransplant Success Story

A First For Texas

A Robotic Autotransplant Means Relief for Molly Sager Harvell

No Treatment, No Medication, No Amount of Rest Would Make the Pain in Molly Sager Harvell’s Right Side Dissipate. For 17 Years, She Suffered.

First, doctors thought it was her gallbladder, so they removed it, but the pain returned. Then in 2011, when it became chronic, they prescribed heavy narcotics. Dozens of specialists put her through dozens of tests — and came up with nothing.

“They were saying, ‘There is no cure; there is no treatment except pain management,’” Molly recalls. “The medicines were so strong but would only dull the pain — it never went away. I felt disconnected from the world.”

Physically, she couldn’t exercise or do activities she once enjoyed like playing with her dog, fishing, and camping. Emotionally, she couldn’t keep up relationships with family, friends, even her husband.

An Unexpected Solution

Hopeless and depressed, Molly turned to a support group. When another group member heard Molly’s story, she could barely contain her shock.

“I’m sorry to interrupt you, but I have what you have,” the woman said. “I have LPHS, and I know a doctor who can help you because he helped me.”

LPHS — short for loin pain hematuria syndrome — is a rare condition that causes persistent or recurrent pain in the flank (upper abdomen, back, and sides) and blood in the urine.

“Normal nerve fibers that go to the kidney become aggravated and produce an ongoing pain syndrome over the kidney,” explains Richard Dickerman, MD, FACS, surgical director for kidney and pancreas transplant, general surgery, and vascular surgery at Methodist Dallas Medical Center. Dr. Dickerman has transplanted more than 2,500 kidneys since starting the hospital’s transplant program in 1981.

The cause of LPHS is unknown, and the most common treatment is pain medicine. But thanks to that support group meeting, Molly learned of another option: an autotransplant. The affected kidney is removed and then replanted several inches lower in the body to avoid the disrupted nerve fibers and alleviate her pain.

“Only certain conditions benefit from autotransplantation,” explains Alejandro Mejia, MD, FACS, executive program director of organ transplantation at Methodist Dallas. “Both of Molly’s kidneys worked; we just needed to move one to the other site to alleviate the pain.”

The Day the Tide Turned

The doctors told Molly not only could she soon live pain-free, but she could also be a “first.” She was an ideal candidate for the first robotic autotransplant in Texas using the da Vinci® Surgical System.

“When we evaluated Molly, we knew she would be the perfect candidate for our first robotic autotransplant,” Dr. Dickerman says. “Even the next day, she was a new person, and we are thrilled we could take her pain away with a minimally invasive transplant procedure.”

Robotic retrieval and implantation is incredibly rare, especially in the same patient, but such advanced procedures are part of Methodist Dallas’ reputation.

Intuitive Surgical, the maker of the da Vinci® Surgical System, named Dr. Mejia a hepatopancreaticobiliary epicenter surgeon. With this distinction, he trains surgeons from all over the world on how to use the robotic system. Methodist Dallas was the first in the nation to be certified by The Joint Commission for pancreatic surgery, in part because of its expertise with robotic procedures.

“It’s been very gratifying as a surgeon to see how this changed Molly’s life, and I was honored to be part of the team,” Dr. Mejia says.

The entire procedure took 2½ hours, and Molly spent three days recovering in the hospital. Within days, she was walking her dog and living without pain and prescription pain medicine.

From the summer 2017 edition of Shine magazine.