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Sunday, March 25, 2012

Dick Cheney Heart Transplant: What’s Ahead

By Michael Smith, MD

After a more than 30-year history of heart problems, former Vice President Dick Cheney is recovering from a heart transplant. How successful is a heart transplant in a 71-year old man and what does the road ahead hold in store?

Cheney suffered his first of five heart attacks in his late 30s. In 2010 he received an implanted device called a left ventricular assist device (LVAD). LVADs were originally intended as a “bridge” to heart transplant while someone waits for an available heart. However, in recent years the technology has improved to the point that people are living for many years with this device, which helps pump blood through the heart. In a previous interview after receiving his LVAD, Cheney had said that he was not sure if he wanted a heart transplant, but he had apparently been on the heart waiting list for 20 months.

Heart transplants are truly life-saving procedures. The surgery is done when no other treatment options are available and there is a good chance the person would die in the near future without a new heart. Of course, LVADs have helped increase the amount of time people can wait for a heart. About 75% of people live for at least five years after a heart transplant, with 56% surviving at least 10 years, according to the National Institutes of Health.

The question is: how does someone in his 70s fare after such major surgery? Quite well, actually, and the latest research suggests that people over 70 do just as well as younger people after a heart transplant.

Cheney will likely spend one to two weeks in the hospital and then his doctors will watch him very closely over the next three months while his body continues to recover from surgery. If all goes well, Cheney should be able to return to his normal level of activity. In fact, with a brand new heart, the hope would be that he’ll be even better than before.

One of the most significant concerns after receiving a new heart is rejection since our immune systems are trained to get rid of any foreign substances, including new organs. To prevent rejection, Cheney will need to take strong medicines to suppress his immune system. This comes with its own risks as these medicines increase the threat of potentially serious infection and even cancer. But keep in mind that people who receive a heart transplant have no other options in order to survive.

At any given time there are about 3,000 people in the U.S. on the waiting list for a heart transplant. But only 2,000 donor hearts are available each year. Do the math. There are many people in the waiting list that never receive a new heart and they die waiting for one. For those who are lucky enough to get a new heart, waiting times vary from days (for emergency situations) to many months, as in the case of Cheney.

One issue is finding a heart that is a match, meaning the genetic profile of the donor is a close enough match to decrease the likelihood that the heart will be rejected. Assuming the need is similar between two patients, the one who has been on the waiting list longer will typically receive a newly available heart.

Over 100,000 people are currently waiting for an organ transplant and 18 people die each day waiting. As a donor, you could save the lives of up to 8 people. That is why it’s so important to be an organ donor. Learn more now.

Posted by: Michael Smith, MD at 10:35 am

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