Dr. Linda Cendales’ journey to associate professor of surgery at Duke University School of Medicine and director of Duke’s hand transplant program hasn’t been easy, but it’s one she’s dreamed of since her days as a medical school student in Mexico City. Originally from Bogotá, Colombia, Dr. Cendales was awarded a scholarship in high school and completed her International Baccalaureate program in Swaziland, but it wasn’t until her research year studying immunology and rheumatology in medical school that she began to consider the possibility of hand transplantation.
“When I was studying in Mexico City,”she explains, “I met a very pleasant lady who had severe hand deformities from rheumatoid arthritis. I wondered what a hand transplant could do for a patient like this; kidney transplantation was a routine therapy and she was already on immunosuppression medication.”
The thought stayed with her as she completed a fellowship at the Christine M. Kleinert Institute for Hand and Microsurgery in Louisville, Kentucky. There, she helped establish the first hand transplantation program in the country and assisted in performing the first two hand transplant procedures.
Dr. Cendales continued to build her career at Emory University in Atlanta before joining Duke’s Department of Surgery to start its hand transplantation program in 2014. “The decision to come to Duke was multi-factorial,” Dr. Cendales says. “It was a next step in my career and the institution itself – its renowned teams in transplantation, plastic surgery and orthopedic surgery, its support for innovation and its excellence. I’ve also found Durham to be a very pleasant place to live. The quality of life is high. I like the comfort and easiness to live in this area. It’s been a good move for me.”
Although Dr. Cendales joined Duke just two years ago, she has been in contact with her most recent patient, Rene Chavez of Laredo, Texas, for the past three years. Rene, who severed his hand in a childhood accident at the age of 4, reached out to Dr. Cendales to inquire about a hand transplant after learning that the procedure was becoming more accessible. At the time, Dr. Cendales was transitioning from Emory and offered to refer Rene to another program, but he opted to wait until she established the new program at Duke.
“In the last three years and with his perseverance, we developed a relationship,” she says, “it also confirmed his commitment to go through a complex procedure like this, and he had plenty of opportunity to reconsider, but he was consistent. By the time we were ready at Duke, he called me again. He was evaluated and approved by the multi-disciplinary committee, and he was transplanted within a week of being on the waiting list. He is recovering and tolerating the medications well and has been doing hand therapy for more than three months. He and his family are very happy.”
As the first transplant of this kind in North Carolina, Dr. Cendales is excited about the potential for growth and innovation in her field at Duke Health. Hand transplantation and the field of vascularized composite allotransplantation (transplants composed of several kinds of tissues) are still being researched, but there are many questions that can be answered that will benefit multiple areas in medicine and surgery.
“I feel very fortunate to work and to collaborate with outstanding people across many disciplines at Duke,” Dr. Cendales says. “We are also training future generations, which is one of our missions. Hand transplantation is not performed at every institution in the country due to complexity, resources and expertise. Certain institutional characteristics are necessary to be able to develop novel techniques and therapies. Duke is clearly one of them.”
The Doctor’s Durham
Favorite Blue Devil experience: I’m a big fan of Duke sports. I go to basketball games at Cameron Indoor Stadium. I’ve enjoyed playing basketball [there] with my plastic surgery partners and residents.
Durham downtime: The weather is very permissive for doing a lot of outdoor activities for longer periods of time during the year. The green spaces are great for walking, jogging and biking. I also enjoy going to DPAC; they bring high-quality events. I also like the Durham Bulls games in the summertime.