Dr. Wells Delivers Father’s Gift to Son
First Parathyroid Transplants Succeed Here
By William Erwin ^
Surgeons here have successfully
transplanted two parathyroid glands
from a father to his 19-year-old son In
what is believed to be the first transfer
ever of parathyroids from one living
patient to another.
Dr. Samuel A. Wells Jr„ an associate
professor of surgery, said he and his
colleagues transplanted the glands 15
months ago and have been following
the patients closely since then.
Both have recovered with no ill
effects, and the boy s immune system
has not rejected his new glands. Wells
said. The father and son live in
Winston-Salem.
The patient, Donald McKnight,
originally came to Duke as a patient of
Dr. J. Caulie Gunnells in the Division of
Nephrology, and he subsequently
received a kidney transplant, also from
his father, John t^cKnight.
When the question of a parathyroid
malfunction arose, Gunnells referred
the patient to Wells.
"We would not expect the
parathyroid transplant to be rejected,”
Wells said, "since the patient was
already taking medicines to prevent the
rejection of his kidney transplant.”
The doctor described the parathyroid
operation last Friday at a meeting of the
Society of University Surgeons in
Tucson, Ariz.
'Parathyroid glands are
yellowish-brown structures about the
size of a pea,” Wells explained In an
interview. 'Normally a person has four
of them in his neck.”
The glands are important, he said,
because they secrete a hormone that
keeps the body’s calcium level
balanced,
■'If the glands become enlarged and
too much hormone is produced, the
patient might develop kidney stones or
bone disease, ' he said. "Occasionally,
as a complication of advanced kidney
disease, all four of the parathyroid
glands become overactive and have to
be removed.”
Such was the case with the
19-year-old.
"He had far advanced kidney
diseases and had all of his parathyroid
glands removed,” Wells said.
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VOLUME 22, NUMBER 8
FEBRUARY 21,1975
DURHAM, NORTH CAROLINA
To keep the boy alive, doctors gave
him large doses of medicine designed
to replace the missing parathyroid
hormone. But the medicine gave him
abdominal cramps and diarrhea.
So the Duke doctors decided to
transplant two of the father s four
glands into his ailing son. Wells said.
"On November 30, 1973, the father
and son were placed in adjoining
operating suites at Duke, " he said.
" Two of the father's glands were
removed from his neck. The glands
were sliced into 13 very small pieces
and these were then implanted into the
muscle of the son’s forearm.”
The surgeons chose the forearm.
Wells said, because the gland pieces
could be removed under local
anesthesia if they ever became
overactive again.
"Following the transplantation, the
young boy’s blood calcium returned to
normal and he again felt well, ” the
doctor said. ‘‘He has been followed now
for over a year and has taken no
replacement medication for nine
months."
“As far as we know, we’re the first to
do this (operation), " Wells said.
(Continued on page 4)
Supplies Worth $1,100
Found in Hospital Trash
Gold has been discovered in the trash
at Duke Hospital.
It’s not the shiny yellow stuff that
everyone would like to have stashed
away in a safety deposit box for hard
times. Rather, it’s another form of
gold—very precious and sometimes
almost as costly.
In case you haven’t guessed, we’re
talking about hospital supplies.
One day in January, Frank Braden,
assistant administrator for patient
services, and four undergraduates hired
for the occasion, searched all hospital
trash that was delivered to the
compactor near the back of the old
hyperbaric chamber.
Their purpose was to discover the
amount of hospital supplies that were
being wasted and the dollar value of
those supplies.
To their surprise and dismay, the total
value of items recovered was
approximately $1,100, ranging from
$750 worth of surgical sutures to
unused bundles of paper towels.
The trash was checked starting with
the first trash run at 8 a.m. and ending
with the last run at 10:45 p.m. All trash
bags were labeled so that they could be
identified by work areas.
The largest percentage of valuable
items were recovered from the trash
early in the morning before 9:30 a.m.,
indicating that these supplies had been
discarded during the night shift. The
least amount of valuable items was
found in the afternoon and early
evening.
Included on the list of unused,
reusable or repairable supplies were
forceps, blood bags, nebulizers, blood
pressure cuffs, trash bags, towels,
dietary trays and silverware, syringes,
stethoscopes, inter-office mail
envelopes, wash cloths, catheters, polar
packs, surgical tape, pepper
dispensers, baby powder, floor wax,
t>ed liners, surgical gloves and clothing,
ointment and urinary drainage sets.
In addition, the searchers found
dozens of used needles which were
discarded into the trash despite the fact
that these needles pose a serious health
hazard to environmental service
workers and that special disposal
containers for needles have been
placed on all wards and in laboratories.
Simple arithmetic shows that if an
equal amount and value of hospital
supplies vyere discarded each day of the
year, in five years the loss would
amount to more than.$2 million. In a
year’s time, the $400,000 represented by
the waste supplies could reduce patient
costs, support more needed research or
pay the salaries of an additional 77
employees, all earning wages at a rate
of $2.50 per hour.
Braden said that he and the students
who helped him with the original search
are planning at least one more
inspection of trash bags in upcoming
(Continued on page 2)
Panel Will Discuss
Hospital Child Care
The Triangle Affiliate of the
Association for the Care of Children in
Hospitals will meet Wednesday at 7:30
p.m. in the hospital amphitheatre.
The meeting will feature a panel
discussion on the effects of
hospitalization on children during early
childhood, middle childhood and
adolescence entitled, “Dialog:
Children's Responses to
Hospitalization.”
Panel members will include Dr. Brian
Stabler, clinical child psychologist at
the University of North Carolina, who
will speak on early childhood and
pre-school aged children; Dr. Cathy
Taylor, child psychologist also from
UNC, who will discuss middle
childhood and school aged children;
and, Dr. David Jones, Duke child
psychologist, who vyill speak on
adolescence.
Following the discussion, coffee and
doughnuts will be served in the
pediatric playroom. All TAACCH
members, their guests and friepds, are*
invited to attend.
* -f-
*
WAITING FOR HER MASTER — There’s an old saying that the most successful
publication of the century might be one about Abraham Lincoln’s doctor’s dog,
since books about dogs, doctors and the 16th president of the United States always
seem to sell a lot of copies. INTERCOM decided to test the proposal last
Wednesday, Lincoln's birthday, by making a photograph that had something to do
with all three. Thus, pictured above is "O.D.", a former research animal who lived to
bark about it and become a growing fixture at the School of Medicine. Her master,
third year medical student and future family practitioner Greg Friedman, was busy
at the hospital that day, and faithful O.D, planted herself outside the Davison
Building to wait for him as she does all day, every day. (Photo by David Williamson)