Duke Health staff gives Fayetteville veteran state's first abdominal wall transplant

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Veteran's abdominal wall transplant is a Duke medical first

A team of 25 Duke Health physicians, nurses, and support staff helped complete the state's first abdominal wall transplant.

37-year-old Johnathan Nauta of Fayetteville is an Army veteran. He began experiencing difficulty digesting food in September of 2014, the beginning of a years-long ordeal of intestinal issues. Numerous infections and ailments led to immense scarring and severe complications. Eventually, he was forced to medically retire from the Army.

"I wasn't able to eat. The TPN (intravenous feeding) was making me tired all the time, making me weak all the time. I had a colostomy bag that I had to empty 10-20 times a day," said Nauta.

He would need extensive, rare surgery to live a healthy life. On top of that, Nauta would need a donor and donor family.



"We decided to make something good out of something bad," said Sherry Scales, the mother of 13-year-old Marcus Scales.

Last month, Marcus died. In memory of his generous spirit, the family donated his organs to help others.

"Meeting Johnathan today has really made it more real for me, and more exciting. He actually showed me my son's stomach for the first time since all of this has happened. And being able to see a piece of my son, to still be able to touch my baby (was special)," Scales said.

During a news conference at Duke Health on Thursday morning, Nauta jokingly compared his surgery team to the university's top-rated basketball team, drawing laughs from a room full of physicians and nurses.

"We found a new and innovative way to reconnect the blood supply to the abdominal wall by creating a vascular loop at the thigh level, so we are staying completely out of the space of the transplant surgeons by performing our revasculation, meaning restoring blood supply to the graft. So with this kind of technique, we can work at the same time doing both transplantation procedures without interfering with each other," said Dr. Detlev Erdmann with Duke Health.

Nauta also required a simultaneous bowel transplant.

According to Duke Health, the success of the surgery advances potential for patients who may need kidney, liver or intestinal transplants, but have severe scarring, hernias or defects of their abdominal wall from previous injury or surgeries.

"It takes so much infrastructure and effort. That's part of the reason why only 20 have been done over the 20 years," said Dr. Erdmann, citing a report from the United Network for Organ Sharing highlighting the rarity abdominal wall transplants.

Carolina Donor Services helped facilitate the donation.

"This was an extraordinary case in which Marcus and his parents gave the ultimate gift, the gift of life to six different recipients through eight of his transplanted organs. For a variety of reasons, on average between three-and-a-half and four organs are transplanted from one donor," said Danielle Niedfeldt, the President and CEO of Carolina Donor Services.

With his new lease on life, Nauta plans to be an advocate for organ donations.

"I just want to take full advantage of this gift, and just live life to the fullest," he said.
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