Patient Who Needed Heart And Kidney Transplant Borrowed Time With Heart Assist Device

Main Category: Transplants / Organ Donations
Also Included In: Medical Devices / Diagnostics
Article Date: 06 Aug 2008 - 2:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

Seven years after Joaquin Lucio's kidneys shut down, he had a heart attack and was taken to a Los Angeles area hospital where doctors performed an angioplasty to clear his coronary arteries. He also was suffering from idiopathic congestive heart failure - a condition in which the heart becomes weak and enlarged - and a special pacemaker was implanted to provide support.

But his heart continued to fail, and the Culver City resident was quickly transferred to Cedars-Sinai Medical Center.

"He had end-stage heart failure and was at the brink of death when he arrived. Output from his heart could not be maintained even though he was receiving maximum intravenous medications in the ICU," said cardiothoracic surgeon Sinan Simsir, M.D., who assumed a leadership role a year ago with the Heart Transplant and Ventricular Assist Device Program at the Cedars-Sinai Heart Institute.

Lucio, 41, needed a new heart and kidney, but with potential recipients outnumbering donations, the organs would not be available in time. To keep him alive, Simsir implanted a HeartMate XVE left ventricular assist device (LVAD) on Dec. 1, 2007. An LVAD takes over the function of the left ventricle, the heart's main pumping chamber.

"We had to implant the device in an emergency operation. He was then able to go home to wait for a donor heart and kidney to become available," Simsir said.

The HeartMate XVE can function as a bridge to transplant, as was the case with Lucio, or it can be used as "destination therapy," supporting the heart indefinitely.

Lucio was one of the fortunate few for whom organs became available sooner rather than later. On Saturday night, Jan. 5, he received a call from a heart transplant coordinator at Cedars-Sinai who said a donor heart and kidney were being evaluated. A few hours later, a second call came: The organs were in good condition, and surgery was scheduled for Sunday at noon.

"I was scared and happy and surprised at the same time," Lucio said. He and his wife, Yolanda, got to the hospital early in the morning. He was readied for surgery and they waited anxiously for bad weather to clear and a helicopter to arrive with the organs.

The two-stage operation got underway at about 3:30 p.m., with the heart transplant team headed by Simsir and the kidney team led by J. Louis Cohen, M.D., surgical director of Kidney Transplantation. Both organs functioned well, and Lucio was on his feet for short walks the following day.

The father of a 7-year-old girl and a 4-year-old boy, Lucio worked 17 years in golf stores, repairing and maintaining clubs and other equipment. He continued working after his kidneys failed, even while undergoing nightly dialysis. After his heart attack and the onset of heart failure, he was no longer able to work and began receiving disability payments.

"He is a young guy with a great family. Without the transplants, he would not have the quality of life that he now can expect. And without the pump, he would not have survived at all," said Simsir. "Our staff and transplant coordinators make every effort to help resolve financial, insurance and funding issues, and it's very rewarding for us to see that patients receive the medical care they need."

In 2007, Simsir and his colleagues performed 43 heart transplants, up from 25 the year before, making Cedars-Sinai one of the top 10 heart programs in the nation. The medical center's lung transplants rose from 11 in 2006 to 26 in 2007, placing the lung program in the top 20 nationally. And with 19 pump procedures performed last year, Cedars-Sinai is among the leading LVAD centers.

Cedars-Sinai's kidney transplant program is among the nation's leaders, having performed about 140 transplants last year. Under the medical leadership of Stanley Jordan, M.D., the program has protocols available to patients thought not transplantable, allowing them to undergo successful kidney transplant.

Lucio is slowly rebuilding his stamina and planning to eventually go back to work. For now, he is enjoying spending time with his family and taking the kids to the mall, to church, or sometimes taking them out for pizza.

Cedars-Sinai Medical Center