Recipient Gives Heartfelt Thanks : Transplant: San Pedro longshoreman who received twice-used heart leaves hospital two weeks after historic surgery.

When John Ferrandino arrived at UCLA Medical Center just over two weeks ago, his heart was failing and he hovered near death. The husky longshoreman left the hospital Thursday morning in a glare of television lights, the suddenly prominent owner of a heart that had belonged to two people before him.

“I get a second chance at life, and I feel it’s wonderful. The donors--I love them,” said Ferrandino, 42, his voice wobbly with emotion, after returning to his San Pedro home.

The June 20 surgery has attracted publicity because UCLA doctors say it appears to be the first time in the United States that a donated heart was given to one recipient and then another. They know of only two other cases in which a heart has been transplanted twice--in Switzerland and in Germany.

Ferrandino’s new heart originally belonged to a 20-year-old woman who died after a traffic accident. That heart went first to an ailing man in his 40s who had been hospitalized for three months at UCLA Medical Center, waiting for a heart.

Although the man recovered rapidly after the transplant, he suffered a brain hemorrhage just as he was to be discharged and died two days later. With his family’s permission, doctors gave the heart to Ferrandino because his condition was faltering and no other suitable heart could be found.

Doctors have declined to identify the first donor and recipient.

UCLA transplant cardiologist Dr. Jon Kobashigawa, who pushed Ferrandino’s wheelchair out of the hospital Thursday, said the case inspires conflicting emotions because although one patient was saved, another died.

“It’s bittersweet. Bitter because we lost one,” said Kobashigawa, director of the UCLA Heart Transplant Clinic who treated both men.

Doctors say that Ferrandino was close to death when he received the transplant, and that he might have had to wait months for a heart if the heart was not rused.

Now, Ferrandino’s chances of living a virtually normal life are expected to be the same as someone receiving a heart directly from the original donor, Kobashigawa said. Ferrandino will continue taking cyclosporine, an anti-rejection drug.

Among UCLA heart-transplant patients, 84% have survived their first year after surgery; 71% for five years. Some have been able to return to sports such as skiing, surfing or basketball, Kobashigawa said.

“They are not crippled, they are not invalids,” he said.

Ferrandino said he hopes to return to light-duty work as a longshoreman.

Doctors say the Ferrandino case illustrates a chronic dilemma--how, despite dramatic advances in medical technology, transplant procedures are still shackled by the chronic shortage of organ donors. In the United States last year, 2,567 people died waiting for organs to be donated.

Reusing organs will not make a significant dent in the lack of donors because reuse requires specific circumstances, doctors said. For instance, the first recipient must die from causes unrelated to heart problems, and the heart must be undamaged.

Giving Ferrandino a re-transplanted heart “was a thoughtful and intelligent thing to do, but this isn’t the solution to the organ shortage,” said Dr. Tom Rosenthal, director of the UCLA Medical Center kidney transplant program. “It does dramatize the fact that there is an organ shortage.”

Records at the Virginia-based United Network for Organ Sharing, which oversees patient waiting lists, show a widening gap between the number of people waiting for hearts and available organs.

The number of annual heart transplants in the United States rose steadily from 1,438 in 1987 to 2,173 in 1992. But while only 699 people were waiting for hearts at the end of 1987, that number had jumped to 2,693 by the end of last year.

Ferrandino, stricken with a weakening of the heart known as dilated cardiomyopathy, was first listed as a possible recipient last November, said his wife, Pearl.

His close-knit family watched helplessly as the six-foot-tall father of two struggled with heart problems for years. Simple tasks such as mowing the lawn became difficult.

“For him to walk, even, was a chore,” said his sister, Mary Ferrandino, 32, also of San Pedro. “It was devastating to watch such a strong, vital person go down to hardly doing anything.”

When Ferrandino’s condition worsened, he was admitted to UCLA Medical Center on June 16. His mother, Anna Ferrandino, went to church daily and lighted candles to St. Anthony praying that her oldest son would live.

On June 19 the man who first received the heart 11 days earlier died after suffering a brain hemorrhage that doctors say was unrelated to the transplant. Doctors transplanted the heart again in a four-hour operation in the early morning hours of June 20, Father’s Day.

Dr. Davis Drinkwater, who performed the surgery, told reporters Thursday that the procedure was much like a routine transplant involving a heart from an original donor.

“The case points out that we don’t want to bury any possible organs that are working, when it’s ethically approved and we are in complete agreement. The shortfall (of donor organs) is such that we can’t afford to lose any possible donor,” Drinkwater said.

Drinkwater called the Ferrandino transplant a unique case. Several transplant experts across the nation concur, saying they are familiar only with the 1991 Switzerland case, which was reported in the Feb. 4 issue of the New England Journal of Medicine. UCLA was contacted by German physicians Wednesday about a another transplant using a recycled heart.

The UCLA transplant is probably the first reported case in the United States, said Dr. Michael Kaye, editor of the Chicago-based Journal of Heart and Lung Transplantation.

Physicians say that reuse of other organs may be feasible. Indeed, a June 3 letter in the New England Journal of Medicine describes how doctors in Spain last year reused a transplanted kidney. And doctors at UCLA say they are not ruling out reuse of kidneys or even livers.

Publicity about the Swiss and UCLA cases may make doctors nationwide more willing to try such procedures, experts say.

Amid all the discussion of new medical frontiers, the Ferrandinos say they are just grateful that a donor heart was found in time.

“John has so much color in his face. You can tell he’s looking so much toward the future,” said Mary Ferrandino.

Ferrandino 10-year-old daughter, Nicole, hovered in the background as television reporters interviewed the doctors and her parents.

Already, her father looks much better, said Nicole, whose fourth-grade teacher explained to her how heart transplants work. She said she is excited her father is home.

“When he feels a little bit better,” Nicole said, “We’re going to throw a big party for him.”