Unidentified Man’s Heart Used in Transplant

The heart of an unidentified man who was shot in the head was transplanted Sunday afternoon at UCI Medical Center after police and hospital authorities unsuccessfully tried to find out his name and reach relatives.

It was the second time in the county’s four-month history of heart transplants that doctors harvested the organ of an unidentified donor, a legal but relatively rare procedure.

The donor, who appeared to be a Latino about 25 years old, was brought to the hospital’s trauma center from Placentia about 11:30 p.m. Friday and was declared brain dead shortly after 9 a.m. Saturday, UCI Medical Center spokeswoman Elaine Beno said. He was kept alive on life support systems while authorities attempted to identify him and find relatives or acquaintances.

His heart was transplanted into a 31-year-old Garden Grove man suffering from cardiomyopathy, a disease of the heart muscle, Beno said. The recipient had been at the hospital since being admitted Aug. 24 for heart failure, she said. “He’s really sick.” His name was not released to protect his privacy, she added.

7th Transplant in County

The 5 1/2-hour surgery was the seventh heart transplant performed in Orange County. The procedure currently is done only at UCI Medical Center in Orange and Hoag Memorial Hospital Presbyterian in Newport Beach. It was UCI’s fourth heart transplant; Hoag has performed three.

The Orange County coroner’s office approved the transplant, a deputy coroner said. Under usual transplant procedures, relatives must give permission for the donor to be taken off life support systems and for organs to be harvested. Under state law, the coroner is empowered to make the decision when the person is unidentified, the deputy coroner said.

“After a diligent search for next of kin or responsible individuals, the coroner has the opinion that all of the criteria to be met for his authorization of the transplant have been met,” Deputy Coroner Ted Sullivan said. Sullivan said he was not authorized to release any more information about the case.

Hospital and police officials attempted to identify the man, in conjunction with the coroner’s office, they said. Placentia police fingerprinted the victim at the hospital and checked the prints against Orange County and California fingerprint files but came up with nothing, Beno said.

Social Security Number Found

A Social Security number was found on the man, “but that turned up nothing,” Beno said.

Police also returned to the crime scene to interview people, making it clear that they were trying to reach relatives because the man was seriously ill, but to no avail, she said.

On Saturday night, the hospital gave out the victim’s description to the news media, including the Latino media, to locate relatives or acquaintances.

He was described as 25 years old, 5 feet 8, 150 pounds, with a four-inch scar down the inside of his left forearm.

Placentia police said they received no calls in response to the media reports. Beno said the search did not extend to Mexico because authorities did not know the victim’s name to trace relatives there.

Placentia police said the man was discovered shot outside a residence in the 300 block of West La Jolla Street shortly after 11:20 p.m. Friday. Officers arrested Miguel Vega Montoya, 45, of Placentia on suspicion of attempted murder.

The investigation was still ongoing to determine what occurred, the motive and the relationship between Montoya and the victim, Placentia Police Sgt. Steve Toth said. No further information was available Sunday.

Admitted Friday

Hospital spokeswoman Beno said Sunday that the wounded man was “in pretty bad shape” when he was brought into the trauma center Friday night.

His blood and tissue samples were tested and typed during the weekend for a possible match with people in the Southern California area in need of heart and kidney transplants, she said. A test also was run to determine that he did not have AIDS, she said.

She said the heart transplant recipient at UCI Medical Center was rated by the Regional Organ Procurement Agency as the most severely ill potential recipient with blood type 0 in the region.

The heart transplant waiting list is coordinated by ROPA, headquartered at UCLA. Patients on the list receive organs based on severity of their illness, how long they have been on the list and the best tissue match, Beno said.

The operation to take the wounded man’s heart began at 12:41 p.m. Sunday, and the heart transplant began at 1:35 p.m. and ended at 6:05 p.m., she said. The unidentified man’s kidneys also were harvested. One of the kidneys was transplanted into a patient at UCI Medical Center. The other was made available to the regional procurement agency.

The heart recipient did not pay for the operation, estimated to cost from $100,000 to $150,000, said Leon Schwartz, hospital director. But the man is eligible for Medi-Cal coverage and the hospital will “deal with the state on the level of reimbursement,” Schwartz said.

UCI Performed 1st Transplant

UCI Medical Center performed the county’s first heart transplant on April 8.

Some critics have charged that the county does not need two transplant programs and that the financially troubled UCI Medical Center cannot afford the costly heart transplant program.

In the 1987-88 fiscal year that ended June 30, the hospital showed a deficit of $5 million. UCI Medical Center is forecasting losses of as much as $11 million by next June 30.

Schwartz, however, defended the transplant program as necessary for the teaching hospital’s cardiac surgery residents.

“It will be an important part of this university hospital in Orange County,” he said. “We are a university teaching hospital. It’s part of becoming a major medical center.”

Sunday’s operation was the second time that an unidentified man’s heart was taken for transplant. The first occurred April 20, when Hoag performed its first heart transplant. The heart of a 19-year-old Costa Mesa man, found unconscious outside a convenience store, was transplanted into a 58-year-old Fountain Valley doctor seven hours after the unidentified man was declared brain dead.

Although hospital officials said proper protocol was followed, the transplant focused attention on the ethical issues involved in discontinuing life support systems and harvesting organs without the donor’s or family’s permission. The donor’s family, located after the transplant, said they approved of the procedure.

According to authorities, under the California Uniform Anatomical Gift Act, a hospital may authorize the donation of organs if no relatives are available after a number of conditions are met.

Among the requirements: There must be a “diligent search” for next of kin that lasts at least 24 hours; local missing persons records must be checked; the patient’s “personal effects” must be examined, and anybody visiting the patient or reporting the death must be questioned.

Times staff writer Lonn Johnston contributed to this article.