Friday, November 13, 2009

Waiting, and Hoping, For a Heart

A patient, recently listed for cardiac transplantation, tells his story about being rejected, then accepted, to the cardiac transplantation list:
Next week, I'll check into Mayo, one of the world's premier hospitals, to undergo additional treatment in preparation for receiving a new heart. Since my brain tumor turned out to be benign and my prostate cancer has responded to treatment, doctors there said those issues no longer should disqualify me as a candidate for a heart transplant.

Now that I'm on the list, I am on an around-the-clock standby alert. I have to be ready to be on the operating table within four hours once a compatible heart becomes available. The fact that Chicago is 331 miles from Mayo, in Rochester, Minn., complicates things since I don't have my own charter jet. But the Mayo Med Air charter service could assist me if a commercial flight can't get me there quickly enough.

The challenge now is the wait. The heart I need will become available only when the donor is declared brain-dead and his heart can be taken from him and implanted in me within four hours. I am told the fact my blood type is B positive increases the chances of me getting a transplant quicker, though there are other patients ahead of me.

I had wanted it all to happen at the University of Chicago Medical Center, where world-renowned Dr. Valluvan Jeevanandam, who performed a triple-bypass on me in 2001, has done more than 1,000 transplants. But that hospital takes a more conservative approach to the fact my prostate cancer still is in remission. They wouldn't put me on the transplant list until I had been using an implanted heart pump ''for several years.''

Fortunately, the Mayo Clinic and Northwestern Memorial Hospital feel I have progressed enough in my recovery from the slow-growing prostate cancer to be eligible for a heart now.
With the competetion for patients underway as the large health care system land-grab extends across state lines and overseas (See here and here), have the selection criteria for transplant patients remained a form of rationing or really become a form of marketing?

I wonder.



Anonymous said...

Seriously, how old is this person? If you have prostate CA you can't be too young (even if it is in 'remission'--and all you doctor-types know that the 5-year survivability of prostate CA is the same if you get 'full' treatment or eat baloney sandwiches). After doing a cardiac transplant for a 50ish gentleman with CRI and diabetes (who received a healthy 19 y.o. heart) I personally shredded my donor card. The hospitals love to talk about that preteen/teenager who received a new organ and went on to live a normal life but a majority of the organs (in my experience) go to those who have little life expectancy left.

Anonymous said...

I think everyone has the right to life. This is sacred. The fact that there are medical centers who are willing to give you a chance to fight for life and not worried about their statistics is admirable.

As a 36 year old with cardiomyopathy who was able to go to class I from III with a bivent, going back to congestive heart failure and needing a heart transplant is my biggest fears. I also have an abonormal origination of circumflex artery and always wondered if in case I do need a surgery for bypass or transplant if they could do it or I would be rejected. This is a question I am afraid to ask my cardiologist. Hopefully I would never have to discuss it. The fact that there are places like Mayo Clinic is encouraging that would never give up. I am surprised about University of Chicago rejecting the guy as they are known as the place who would take cases that no one else would take.