This holiday season, Valance Sams, Sr. hopes to finish the most important thank-you note he’s ever written—one he’s been pondering for months. It’s been challenging to get all that he wants to say down on paper, in just the right way. Most days, a flood of emotions gets in his way.
Sams’ note is for the family of the 21-year-old man whose heart, liver and kidney are living on in his body, the result of a 20-hour triple transplant he underwent at Cedars-Sinai in May.
How do you adequately thank a family for a gift borne of such generosity and sadness? Sams is still processing his good fortune to receive three organs at once and wonders how the donor’s family is managing their own feelings.
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“It makes me emotional when I think about how these three organs have changed my life,” Sams said. “I prayed every day for a miracle when I was waiting for a transplant. I knew what I was up against, and that the wait would be tough.
“I got my miracle. But I feel sad that this young man’s family had to go through what they went through in order for that to happen.”
Sams became only the 46th person in the U.S. to receive a heart, liver and kidney transplant since the United Network for Organ Sharing, the government agency that tracks organ transplants, started tracking in 1987.
His triple transplant was Cedars-Sinai’s first successful triple transplantation; the hospital performs more dual organ transplants than any other transplant center in the U.S. Last year, Cedars-Sinai hit a new high for organ transplants, completing 616—which topped the previous year’s high of 556.
For 10 years, Sams had been living with sarcoidosis, a rare inflammatory disease that caused a buildup of scar tissue on his heart and left him unable to work or even walk. Over time, he required multiple visits every week to his doctors to monitor his condition, drain built-up fluids from his body and administer dialysis treatments.
But his health took a turn for the worse early this year when his heart, liver and kidneys began to fail.
“If the heart’s not working, it can cause something called congestive hepatopathy in the liver, where the liver just starts not to work very well and can cause chronic and permanent damage of the liver, and then it can also cause stress on the kidneys as well,” said Irene Kim, MD, director of the Cedars-Sinai Comprehensive Transplant Center and the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine.
Sams was in the hospital for two months before a matching heart, liver and kidney were available for transplantation.
Sams’ surgeons — Tyler Gunn, MD, director of the Extracorporeal Membrane Oxygenation Program; Nicholas Nissen, MD, surgical director of the Liver Transplant Program; and kidney surgeon Justin Steggerda, MD – worked together with their teams of up to 15 other providers at a time to transplant the organs. The highly orchestrated procedure required close alignment among the teams and detailed planning.
“The coordination started long before we even got to the operating room,” Steggerda said. “It started with our program coordinators and our respected nursing staff, who made sure that a donated organ was acceptable, identified the best time to do the procurement and organized the logistics of getting all the teams there to get the organs and bring them back safely.”
During multi-organ transplants, surgeons operate based on allowable “ischemic” time—the amount of time each organ can tolerate being outside the body. Based on this, Sams’ heart transplant happened first, followed by the liver and, finally, the kidney.
Nissen said that multi-organ transplants like this exemplify transplant teams’ ability to work together under pressure.
“It’s the ultimate example of medical teamwork,” he said. “Literally every team member has to work with every other team member for this to go right. There are three different teams that are making this happen, so for this to be successful, it takes an absolutely coordinated effort.”
Fast-forward six months, and today, Sams is feeling “wonderful.”
He’s keeping in mind his physicians’ advice: The more he moves, the better and faster his recovery. And so, he walks more than a mile three times a week and makes sure to get in cardio exercise and plenty of stretching. There’s no huffing and puffing as he climbs the stairs at Los Angeles Trade-Technical College, where he’s taking classes with the goal of earning a degree in sports psychology.
“I thank the Cedars-Sinai transplant team for having everything down to a science,” Sams said. “I have so much to be thankful for, from all my doctors and nurses to everybody who helped me along the way. And I’m thankful for life—to be as sick as I was and then to come out of it 10 years later with no health problems—it’s the miracle that I prayed for.”
He is also eager to get back into coaching youth baseball and giving back to the community. He’s even hoping to start his own nonprofit to help dialysis patients.
But first, he wants to finish the most important thank-you note he’s ever written, for the most meaningful gift he’s ever received.
“I’m hoping and praying that the donor’s family would like to meet me one day,” Sams said. “It can be hard for people who need an organ to get one, let alone three—and it would mean the world to me to know more about the person who made that possible.”
