Friday, January 16, 2009

Mass General performs record-setting number of heart transplants in 2008

As 2008 drew to a close, Jim Murphy of Lynnfield, reflected on the challenges of the past year and on the new heart that helped make a happy and healthy new year possible. He was not alone. Jim was one of 28 patients who received heart transplants at Massachusetts General Hospital in 2008 - a record number for the program and more than any other medical center in New England.

“Mass General has demonstrated a commitment to excellence in heart transplantation,” says Joren Madsen, MD, DPhil, director of the Transplant Center at Mass General and section chief of cardiac surgery. “The directors of the heart transplant program have been making improvements to the program continuously, and this year we have seen the impact of their work.”

The 28 heart transplants represented a 70 percent increase over the number completed in 2007. In addition, Mass General also decreased patients’ time-to-transplant after being placed in the organ list. Patients averaged just fifteen days on the waiting list, and their length-of-stay in the hospital averaged just 15 days.

“Ten years ago patients could expect to be hospitalized for an average of 60 days for a heart transplant. This is an enormous improvement over the past decade,” says Madsen.

“Mass General has employed a smart, aggressive approach to evaluate donors based on thorough, invasive monitoring,” explains Madsen.

“Our goal is to maximize the potential of every donor heart without impacting the outcomes of our patients. We have shown that we can rapidly transplant listed patients. It is simple - the more patients we list, the more patients we will transplant,” says Bruce Rosengard, MD, FRCS surgical director for the cardiac transplantation program.”

While aggressively matching patients with available organs, Mass General also maintained a zero percent early mortality rate for its heart transplant patients. The 2007 survival data was 89 percent after one year, better than the national average.

Improvements in heart transplantation can be attributed in part to the management of the organ donors. In 2007 the United Network for Organ Sharing (UNOS) developed DonorNet to improve the organ allocation process for the transplant community. The system allows transplant centers to procure organs more efficiently and from broader regions of the county.

By increasing access to organs, the whole region has benefited from an increase in heart transplants. According to the New England Organ Bank, in 2007 New England hospitals completed 78 heart transplants. In 2008 there were 105, a record number for the region.

One Patient’s Story

Jim Murphy benefited from each of these program advancements along his road to recovery. A few years ago, Jim was in peak condition. He was a personal trainer and often competed in amateur Strongman events. Then he found himself getting winded just walking short distances.

When he nearly passed out carrying a small television up a flight of stairs, he knew he needed help. Doctors managed his condition with medications, but in December 2006 he was diagnosed with class IV heart failure and received a cardiac resynchronization device to regulate the beating of his heart.

His family heard more bad news in May 2007, when Jim’s father was diagnosed with liver and stomach cancer.

“He died just after New Year’s [2008]. We didn’t expect it to happen so quickly,” Jim says.

While struggling with his father’s passing, Jim faced new problems with his heart and was eventually hospitalized at Mass General. Jim and his family received much needed good news in early June when his name was added to the heart transplant waiting list, and on the same day a new heart was found for him.

Jim was discharged five days after his transplant surgery, and his first weekend home was Father’s Day. “I told him that this was a sign that his father was looking out for him,” says Stephanie Moore, MD, Jim’s heart failure specialist at the Mass General Hospital Heart Center.

After getting the go-ahead from his doctors, Jim plans to head back to the gym to start Strongman training again, marking a happy ending to a hard fought year.

“I used to have a couple of good days followed by two weeks of bad days. Now I have almost all good days,” says Jim. “I am able to do stuff I was not able to do for three years. I can get out there and push myself. The difference is amazing.”

Patient Access

Stories like Jim’s are becoming more common. Heart failure is a growing epidemic in the United States with approximately 550,000 new cases diagnosed annually. To meet the mounting need, the heart failure program has improved the access of patients to clinicians specializing in their care and expanded its outreach to patients and physicians throughout New England, according to Marc Semigran, MD, director of the Heart Failure and Cardiac Transplant Program at the Heart Center.

“For example, we have launched a program in ultrafiltration and offer heart failure patients access to advanced diagnostics and cutting-edge therapies under development at Mass General in conjunction with the NHLBI Heart Failure Network,” says Semigran.

Drs. Semigran and Rosengard both expect the program to grow, and they are working with Heart Center leadership to build the inpatient infrastructure necessary to support the continued growth.

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