Spotlight: Saving lives is a team effort for longtime transplant surgeon “Dr. C”

Transplant surgeon Srinath Chinnakotla, MD, over the course of his 21-year surgical career, has performed over 1,600 life-changing transplant surgeries, with a special focus on pediatric transplantation.

This includes groundbreaking operations for children of all ages: a liver transplant for a 4 week-old believed to be the youngest liver transplant recipient in Minnesota, a multi-organ transplant for an 11-year-old from Maryland with an incredibly rare form of cancer, and a triple organ transplant (liver, pancreas, and kidney) for a South Dakota child with Wolcott-Rallison Syndrome, among others.

Chinnakotla, who also serves as a surgical director for both our liver transplant program and pediatric abdominal transplant team and as a professor with the University of Minnesota Medical School, credits the multidisciplinary team of specialists at M Health Fairview Masonic Children’s Hospital for making these breakthroughs possible.

“We have an incredibly smart team of specialists that love taking care of children. Everyone feels the joy of improving a child’s life,” said Chinnakotla. “Because of our incredible team, we’re on the forefront, leading the way in pediatric transplantation.”

We sat down with “Dr. C” (as he is known to his patients and colleagues) to learn about his career and what sets our program apart.

Why did you specialize in transplantation?

I interned in liver transplant early in my career, working with patients who had liver disease and were very ill. Immediately after transplant, they got dramatically better. I was so impressed that that one operation could change a person’s life in that way.

I was blessed to study with several physicians who trained directly under transplant pioneer Thomas Starzl: Byers Shaw, Alan Langnas, and Göran Klintmalm. I learned their work ethic, and this training laid the foundation for my surgical skills. Shaw and Langnas also had a strong interest in pediatric transplantation, which inspired me. I do surgeries for both adults and children, but with a special focus on pediatric transplantation.

What brought you to Minnesota?

We have one of the world’s premier transplant programs, and the University of Minnesota has an incredible legacy in pediatric transplantation, including liver transplant. When a position became available 13 years ago, I knew I wanted to apply. At the time, they were building what is now M Health Fairview Masonic Children’s Hospital. It was a brand-new facility and one of their flagship programs was transplant surgery. The hospital also has a multidisciplinary team that supports transplant, which is relatively unique and not available at many other programs.

Organ transplantation is the ultimate team sport: surgeons, anesthesiologists, pediatric intensive care physicians, pediatric hepatologists, pediatric nephrologists, coordinators, pharmacists. You can’t do this by yourself. You need dedicated people at every stage of the process; every person contributes in their own way. At the children’s hospital, everyone is dedicated to selflessly taking care of these children.

What is your philosophy for working with children?

Children understand a lot more than you might think they do. Our approach is to partner with the child. I work with the family, but I also talk to and work with the child. If you make them a partner in their care, and have them participate, it’s better for everyone.

For children, the small things in life are some of the most important. I connect with my patients through learning about their interests and goals. I’ve had children who just want to get back to playing softball or baseball, or who want to dye their hair, and we can work together to make that happen. At the hospital, we help children lead normal lives thanks in large part to the support of our integrative health program and our Child Family Life Services.

What stands out to you about our pediatric transplant program?

We’re able to do things that others aren’t doing, thanks to our expert multidisciplinary care. Last year, we saw multiple young patients who were in liver failure due to a rare outbreak of acute hepatitis. We had the ability and expertise of our infectious disease physicians to help manage their illness before and after transplant.

We’ve worked with several children who needed multiple organs transplanted. For example, Khloe Cox, a young patient who came to us from Maryland with a rare form of cancer affecting both her pancreas and liver. We performed the first-of-its-kind dual liver and pancreas transplant for a neuroendocrine tumor in close collaboration with our pediatric oncologists.

We give hope to all children who come to our program that we always figure things out, and we also offer transplantation to high-risk patients — those who are very sick or, like Khloe, need a multi-organ transplant. We’re trying to provide good follow-up care in the long-term, so that these children are able to achieve their dreams and live life to the fullest. Our program has very good outcomes; for example, we’re proud to have a 100% survival rate at 10 years out from liver transplant for metabolic liver disease.

Can you talk about your involvement with our TP-IAT program?

While I primarily do liver transplants, I also perform islet auto transplants, kidney, and intestine transplants, and have done over 120 TP-IAT surgeries. Total pancreatectomy and islet auto-transplant (TP-IAT) is used to treat the debilitating pain of chronic pancreatitis in both children and adults. We remove a person’s pancreas and rebuild their gastrointestinal tract. We take islet cells, which are responsible for producing insulin to manage blood sugar levels, from the pancreas and place them in the patient’s liver to try to reduce the risk of that person developing diabetes.

We’re changing the paradigm when it comes to caring for kids with chronic pancreatitis. Over the years, we’ve begun offering TP-IAT to younger and younger children because ― contrary to what we thought — we’ve seen that younger children have better outcomes. Over 90% of our patients say their pain is gone or reduced after transplant, and 80% of children under 9 can eventually come off supplemental insulin.