Heart Failure V—Cardiac Transplant in Tampa Bay
The person who actually brought cardiac transplantation to Florida was none other than our own eminent Indian cardiovascular surgeon, Dr. R. R. Vijay, who performed the first successful heart transplant on June 6, 1985, at Tampa General Hospital. I recently interviewed Dr. Vijay who had these comments to share with us.
“I was quite amazed when Dr. Christian Barnard performed the first heart transplant in 1967. Although I myself had done quite a bit of experimental and clinical research in this field at Montefiore Hospital, N.Y., and learned the techniques on dogs, I didn’t think we were quite ready for a human to human transplant mainly because of the high incidence of rejection. When I was practicing cardiovascular surgery at Tampa General Hospital, we had very little to offer for patients with end stage cardiac disease; they just went home and died. But all that changed with the advent of cyclosporine, the miracle drug to suppress rejection, in 1983. At that time, I worked very hard to put together a heart transplant program at TGH and finally TGH board gave me the green signal to go ahead. And on June 6, 1985, I performed the first successful human heart transplant in Florida. And that first transplant recipient, John Thrasher, survived for 12 years and the second patient, Frank Spurling, lived for 34 years, second longest survival in the whole world!”
In celebration of this remarkable achievement, Dr. Vijay was inducted into Tampa Bay History Center, a huge honor, and a new exhibit is on display with Dr. Vijay’s photo and his work – the only Indian to have reached this glorious position so far. Indeed, a proud moment for all of us Indians! In 1997, TGH Board of Directors awarded Dr. Vijay the title of ‘Distinguished Director Emeritus of Heart Transplant Program.’ The program has been running well since then and TGH celebrated its 1000th Heart Transplant recently.
So, what’s the current status of heart transplantation? I will quote the words of Dr. Sandeep Nathan, associate professor and director of Interventional Cardiology program at University of Chicago: “Whereas the early days of cardiac transplantation were fraught with technical and therapeutic issues, which dramatically decreased survival, the operation has emerged 50 years later as a predictable and proven effective therapy for patients with a wide range of severe cardiovascular conditions. According to statistics compiled by the International Society for Heart and Lung Transplantation (ISHLT), over 5,500 cardiac transplants are performed annually the world over, with over 50 percent of these procedures performed in the United States. One-year survival nationally is now approximately 90 percent, with 3- and 5-year survival of 85 and 79 percent respectively, making cardiac transplant one of the most successful solid organ transplantation procedures performed today.
“The University of Chicago’s Department of Medicine has established itself as one of the highest volume cardiac transplant centers in the world, consistently performing 40-50 transplants per year, including a high-risk and re-do operations as well as candidates turned down elsewhere due to medical complexity. Despite the significantly higher baseline risk of our typical transplant candidates, our institutional outcomes meet or exceed national standards. Of note, a new heart allocation policy has been implemented by United Network of Organ Sharing (UNOS) in 2018 to better stratify the urgency for recipients of heart transplants. This and a number of other modifications to patient selection, organ preparation and surgical technique, immunosuppressive therapy and post-transplant surveillance/support continually strive to match the most medically needy patients with the optimal therapy and thus, maximize the likelihood of long-term survival.”
Currently, there are many centers in Florida running successful cardiac transplant programs but Tampa General remains one of the busiest of all and is ranked No. 6 in the nation. TGH also has some of the shortest waiting times in the nation for the organs that they transplant – heart, lung, liver, kidney and pancreas, which is indeed welcome news for the patients.
This concludes the series on heart failure.