A Few Good Hearts

UCLA MEDICAL Center annually evaluates 150 to 200 heart transplant candidates. “Of those,” says Dr. Lynne Warner Stevenson, medical director for UCLA’s heart transplant program, “only about 40 actually get a new heart.” Some are turned away because they have more than six months to live and therefore aren’t considered “end stage” heart patients, or because they’re too ill (other organs are failing as well).

Potential heart transplant patients’ cases are referred to the program by their cardiologists. The cases are then reviewed by cardiologists at UCLA and presented to a committee that meets once a week. In considering each one, Dr. Hillel Laks and Dr. Davis Drinkwater, the two transplant surgeons, are joined by six cardiologists, two psychiatrists, two transplant coordinators, pulmonary and renal specialists, a social worker and an infectious disease consultant.

The most common causes for need are heart failure brought on by coronary artery disease and cardiomyopathy, a disorder usually caused by viral damage to the heart. The average age of transplant recipients at UCLA is about 45. The youngest transplant patient was 7, and the cutoff is 60, with a few exceptions made up to age 65. Once accepted, most patients are put on beepers and sent home to wait for the call that a donor heart is available.

UCLA’s transplant program claims a success rate of 85% to 90% survival the first year and 75% after three years. Still, Stevenson says, the severe shortage of donors is what keeps this “most dramatic of solutions” from being available to all. (The International Society for Heart Transplantation says 14,000 to 20,000 Americans suffer annually with end stage heart disease that would benefit from a transplant, but that just 1,000 to 1,200 donor hearts are available each year.)

At UCLA, medical therapy receives as much emphasis as surgery. With individualized treatment, “about one-fourth of the patients we see for full transplant evaluations are put back on track,” Stevenson says. “They feel so good, they say never mind to a transplant. They’re able to live their daily lives without any limitations.”