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On paper, Maeve Taylor was not the kind of patient on whom a surgeon would choose to operate.
She has a rare bleeding disorder called a Factor XIII deficiency, which causes blood clots to break down and can result in uncontrolled bleeding. A surgical procedure would be very dangerous.
David Foley, MD, a liver and kidney transplant surgeon and Director of the Renal Autotransplant Program at UW Health Transplant Center in Madison, Wisconsin, didn’t feel he should turn Maeve down for a renal autotransplant based on her medical records alone. He consulted with a hematologist at UW Health, and determined that he would, indeed, be able to help Maeve.
“On paper, the risks looked large,” Dr. Foley said. “But after reviewing the recommendations from the hematologist, I felt comfortable that the benefits of the surgery outweighed outweighed the risks.”
Multiple health problems
At age 23, Maeve, who lives in Chapel Hill, North Carolina, had more health issues than any person should in a lifetime. In December 2021, she started uncontrollably vomiting every time she ate, which landed her in the hospital with a feeding tube. She developed gastroparesis, which is delayed emptying of the stomach, and proceeded to lose 50 pounds over the course of several months.
Because she lost so much weight in such a short amount of time, Maeve developed Nutcracker Syndrome, a vascular compression disorder in which the left renal vein becomes pinched between two arteries in the abdomen. As a result, she experienced excruciating pain in her left flank. “I had these horrible backaches and headaches,” she said.
In the meantime, she continued to have trouble eating, which meant she wasn’t receiving the nutrition she needed. At her lowest point, she weighed 100 pounds at a height of 5 feet, 7 inches. In July 2022, her doctor started her on total parenteral nutrition (TPN), an IV form of nutrition.
“My parents and I didn’t know if I was going to make it,” said Maeve. “But once I was put on TPN, I was finally able to gain some weight. I was no longer just trying to survive, and I was able to go back to work full time.”
While Maeve was no longer suffering from malnutrition, she still had the pain from Nutcracker Syndrome. In addition, a vascular surgeon discovered that she also had May-Thurner syndrome, another compression disorder in which the right iliac artery compresses the left iliac vein.
Maeve needed surgical help. Unfortunately, none of the surgeons she saw were willing to help her because of her bleeding disorder—until she saw Dr. Foley.
“Dr. Foley was a godsend,” she said. “I was shocked that he and his team didn’t reject me outright. Instead, they consulted with the UW Health Hematology Program team and came up with a plan to keep me safe. That honestly saved my life. I immediately felt like they saw every aspect of me—not just the problematic part of my medical history.”
“As a liver transplant surgeon, I frequently deal with bleeding issues,” Dr. Foley said. “We have liver transplant anesthesiologists who are comfortable treating patients with bleeding disorders, so we knew we had the tools and expertise available to get her through a complicated operation safely.”
In August 2023, Dr. Foley and his team performed a renal autotransplant on Maeve, removing her left kidney and placing it in her lower right abdomen. There were no complications during the surgery. Though Maeve experienced pain from the procedure itself, she could tell right away that the compression pain was gone.
“It’s like night and day,” she said. “I’m off pain medications and taking walks. I’m so much better than I was before.”
Although Maeve still suffers from gastroparesis, and continues to wean herself off TPN, she feels she has made major steps forward with her health, saying it’s because she found a surgeon who was willing to take a chance with her.
“This surgery has been everything I could have wanted,” she said.