—as told to Lisa Murtha
In 2010, University Hospital disbanded its heart transplant program due to low volume. But three years later, Richard Becker, M.D., opened UC’s Heart, Lung and Vascular Institute with the idea of offering advanced treatment for heart disease. Including transplants. Physicians have performed six heart transplants since February 2016; cardiac surgeon Louis B. Louis IV (who worked at UC from 2010 to 2013) and cardiologist David Feldman, both from Abbott Northwestern Hospital in Minneapolis, were among the program’s first staff recruits.
LOUIS: There are two parts of the surgery. There’s a donor operation and a recipient operation. We do both.
FELDMAN: Dr. Louis tries to get [the heart] from the one who’s donating it to the one who’s receiving it in four hours or less. It’s a race every single time, a coordinated dance.
LOUIS: Because the heart is such an important organ, we don’t trust anyone else to bring it to us. So you get off the plane and you’re met at a point where it’s really just tragic because someone young [is brain dead] and everybody’s really sad. And basically you stop his heart, put it on ice, put it in a cooler, and take that cooler onto a Learjet.
Something happens in that hour flight back, where the world changes. When you land in Cincinnati everybody’s excited because someone is getting a second chance to live.
When the wheels touch the ground we begin cutting out the heart of the recipient. When you bring the cooler in, the patient’s on the heart-lung machine. You take this cold, lifeless, gray piece of muscle—’cause the heart’s just a muscle, an amazingly engineered, miraculous muscle that managed to beat 60 to 100 times a minute every minute of your life—out of a cooler and start sewing it in.
Once you take the clamp off and allow blood to flow into it, you see the organ turn from gray to pink and then all of a sudden it starts to beat. A lot of times, you don’t have to shock it—it just starts beating on its own. That’s the miracle of the operation—it really is. I always take a second and look at this heart beating and think about what an amazing thing just happened.
Immediately after surgery the patient’s taken to the intensive care unit. If everything goes well, and 90 percent of the time it does, the patient is out of bed and walking within 24 hours after the surgery. Just like open heart, except the stakes are a lot higher, physiology’s a lot harder, and the medicines are infinitely more complex because they all get chemotherapy…
FELDMAN: …to stop them from rejecting the hearts. Because sometimes the heart forgets where it is and it just decides it wants to stop on its own unless you have some biochemical way of actually keeping it going. After a while what happens is, no pun intended, it has muscle memory and it doesn’t need those chemicals anymore.
LOUIS: Generally, about a week after the heart transplant, if everything goes well, the patient is going home.
FELDMAN: The greatest risk of rejection is in the first year. Patients are followed up weekly including a cardiac biopsy to assess them for rejection for the first two months. Then it goes to every two weeks and then, after a year, if they’re doing really well, it gets to be one visit every six months. The average heart transplant patient will live more than 13 years in the United States.
LOUIS: For the most part, a patient who receives a heart transplant can expect to live a completely normal life and be able to do all the things they weren’t able to do before. It’s an extraordinary privilege [for us] to get so close to people.
FELDMAN: We have some of the greatest jobs in the whole world.