Travis Kerns, 44, has been an Atrium Health team member for 20 years. As a part of MedCenter Air’s ground transport team, he facilitates critical care transports between Atrium Health facilities, often delivering organs for transplant patients.
In 2021, Travis was diagnosed with a neuroendocrine tumor with liver-only metastases. After his cancer progressed with medical therapy, he learned that he needed a liver transplant. In March 2024, nearly three years after his cancer diagnosis, Travis received the gift of life — a liver transplant. Read on to learn more about his inspiring journey.
A neuroendocrine tumor diagnosis
In 2021, Travis had just gotten a smartwatch and noticed his heart rate was frequently high, even when he was relaxed. When his heart rate continued to be elevated and he noticed bowel movement changes, he saw his primary care provider, thinking he was possibly dehydrated.
His lab results indicated abnormal liver function, so he underwent additional imaging. Imaging revealed multiple large liver masses. After a liver biopsy, Travis was diagnosed with a well-differentiated, low-grade neuroendocrine tumor (NET) that doctors believe originated in the small intestine and had only spread to his liver.
“I was shocked and devastated,” says Travis. “At the time, I was 41 years old and had an 11-year-old daughter, Kennedi. I had so much life to live and I wanted to fight for Kennedi. I was sad for a bit, then I was like, ‘OK, I’m going to beat it.’”
“Compared to common cancers such as breast, prostate and lung, NETs are rare but can vary dramatically from slow growing tumors (which is most common) to aggressive cancers that can spread quickly,” says Dr. Kunal C. Kadakia, a gastrointestinal medical oncologist at Atrium Health Levine Cancer. “NETs are most often classified by tumor grade which describes how likely they are to grow and spread. Low and intermediate grade (Grade 1-2) NETs are often called 'carcinoid' tumors and can lead to diarrhea, flushing and valvular heart disease symptoms. Carcinoid syndrome is most often present when NETs have spread to the liver. Mr. Kerns had symptoms of carcinoid syndrome.”
His initial treatment plan
Travis was treated with octreotide LAR, an FDA-approved drug that can control the symptoms of carcinoid syndrome, such as diarrhea, and control or stabilize the cancer from growing for a while.
“The treatments reduced the size of my tumor, but then it started growing back,” says Travis. “What started out as three masses on my liver ended up being 12.”
Because the cancer had not spread outside of the liver, Travis’ medical team discussed other potential treatment options including liver-directed treatments which are often used in such scenarios. Travis received trans arterial chemoembolization (TACE) to his liver in 2022 and again in early 2023. Despite these efforts, his cancer continued to grow slowly but consistently. Additional therapeutic options were reviewed by his multidisciplinary team including trans arterial radioembolization (TARE) and Peptide Receptor Radionuclide Therapy (PRRT, Lutathera ®). PRRT is an FDA approved form of radiopharmaceutical therapy for somatostatin-positive NETs. While those treatments were being considered, the medical team also suggested that he might need a liver transplant and he was placed on the transplant list in 2023.
Three Atrium Health specialties collaborated on Travis’ care: medical oncology, transplant hepatology and transplant surgery. His medical team included Dr. Kadakia, Dr. Paul Schmeltzer, a transplant hepatologist at Atrium Health Transplant and Liver Center and Dr. Dionisios Vrochides, a transplant surgeon at Levine Cancer Institute.
As part of Travis’ liver transplant evaluation, he was also seen by other members of the transplant team, including the liver transplant coordinators, social worker, financial coordinator, pharmacist and dietitian.
“Most patients are prioritized for liver transplant based on labs that are reflective of liver failure,” says Dr. Schmeltzer. “There are exceptions made in certain cases, including patients with neuroendocrine tumors with a gastrointestinal/pancreatic origin. Based on Travis' favorable tumor biology, he met criteria that increased his priority for a liver transplant.”
Finally getting the call
In March 2024, Travis got the call that he had a match and it was time for his transplant surgery.
“I worked until the day I got called for my transplant surgery,” he says. “I wanted to continue to live as normal a life as possible.”
The medical team used a new liver pump technology to facilitate the process.
“The normothermic machine perfusion pump (NMPP) used in Travis’ case is a recently FDA-approved liver preservation platform that has significantly improved both the recipient outcomes and the logistics of graft allocation,” says Dr. Vrochides.
Atrium Health is one of the initial 20 U.S. transplant centers to adopt this technology. NMPP provides the explanted liver with oxygenated blood during the transportation and storage process. The pumped liver is actually producing bile, which means it is “alive” outside the human body.
“NMPP gives the capability to do two things: First, assess if a liver graft that doesn’t look suitable on paper is actually a good one. Second, NMPP allows waiting longer before transplantation to find the best donor-recipient combination. In Travis’ case, the liver graft was initially rejected by all transplant centers on the East Coast. However, when we put this liver on the pump, it immediately started producing bile. At this point, we realized that Travis had just found the lifesaving organ he needed.”
Travis’ liver transplant recovery
“Travis had a straightforward, uncomplicated liver transplant,” says Vrochides. “He was discharged home after seven days. Ever since, he has been doing very well.”
“I’m doing great,” adds Travis. “It’s like I’m another person. I’ve bounced back, I feel good, I’m in no pain, and I’m getting my strength and energy back. I know the fight’s not over, but I have a very positive attitude. I’m doing everything I can to make the surgery a success. I want to continue to live and enjoy my life.”
His message to others with cancer diagnoses: “Don’t give up. It’s not over. Fight your way through it and keep a positive attitude.”
“As a transportation specialist, Travis transported organs to be transplanted to other patients many times in the past,” says Vrochides. “In a strange twist of fate, he has now received one of the donated livers he had been delivering up until very recently.”
If you’d like to support patients like Travis, please consider donating to the Atrium Health Transplant Fund.
