Heart Health
Why Some Are 'Opting Out' Of Heart Transplants
By
Feb 1, 2010 - 11:22:04 AM

(HealthNewsDigest.com) - COLUMBUS, Ohio) - Thanks to some remarkable technology, patients at Ohio State University Medical Center are choosing to take themselves off of the heart transplant waiting list and are living to tell about it. With the help of a ventricular assist device (VAD), or heart pump, in some cases these heart failure patients can live a full, active life without ever needing a new heart.

Doctors have been studying the effects of the pumps, which take over for one or both of the heart’s ventricles, for some time in patients are whose hearts are too weak to pump on their own. Instead of beating, a small rotor in the device keeps blood flowing constantly. Not until recently, however, were they seen as a po tential long-term solution as opposed to being simply a bridge to transplant.

“VADs are the ultimate rehabilitative therapy and allow most patients to achieve some level of hea ling in their hearts,” says Benjamin Sun, MD, Ohio State’s director of cardiothoracic surgery. “Many people who receive these pumps achieve a very good quality of life, and may decide to keep the pump for years instead of receiving a transplant.”

Results from a recent multi-center trial involving Ohio State and 37 institutions across the country echo that sentiment. The trial, which tested the effectiveness of a smaller, lighter and longer-lasting VAD, show that 70 percent of patients now survive at least a year after receiving the device.* Results were recently published in The New England Journal of Medicine. At Ohio State the number was even higher, with 80 percent of patients doing well after a year.

Some patients like Beverly Thurman, 63, of Gahanna, Ohio keep their heart pumps in for much longer than a year or two. Prior to receiving her pump, Beverly’s heart was enlarged, failing and her heartbeat was erratic. At one point, she could only walk two steps at a time.

Now, four years after her surgery, the device is a part of Beverly’s life. The unit is very small and Beverly carries the batteries that keep it running in a purse. Most of time she doesn’t even notice it. Beverly is doing so well, in fact, she’s taken herself off of the waiting list for a transplant.

“She’s done great,” says Dr. Sun, who operated on Beverly. “The VAD has given her the blood flow so we could have the nutrient exchange that she needed to recover.”

If a heart is available, doctors still suggest that patients get a transplant, however as these pumps get smaller and more efficient, Dr. Sun says they could soon be considered by the FDA as a permanent alternative to transplants.

Sources:
*Data: Waiting list candidates, Organ Procurement and Transplantation Network, U.S Department of Health & Human Services. Retrieved January 2010 from:
http://optn.transplant.hrsa.gov/data/default.asp
**Advanced Heart Failure Treated with Continuous-Flow Left Ventricular Assist Device, New England Journal of Medicine, Volume 361, Number 23. December 3, 2009. Abstract available at: http://content.nejm.org/cgi/content/short/361/23/2241

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