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March 27, 2012

'Bridge to Transplant' Mechanical Pump Almost as Miraculous as Cheney's Transplant Itself

If you’re waiting for a heart, you might be pretty annoyed that former Vice President Dick Cheney, at age 71, just got one.

But according to Fox News’ Dr. Marc Siegel, he didn’t jump any lines. He actually waited 20 months for his new heart, despite his prestigious former job.

A transplant is done when a patient has a damaged or diseased heart and it’s replaced with a healthy one, usually from a person who has died. “It is the last resort for people with heart failure when all other treatments have failed,” according to The Web site also notes that heart transplants are now the third most common organ transplant operation in the U.S.

Siegel reports that it’s not such a surprise that Cheney got a heart. Even though he’s one of the oldest recipients to get a heart transplant, the survival rate for those over 65 is pretty close to 100 percent in the first year.

But as Siegel points out, the heart transplant itself isn’t really the news – it’s the left ventricular assist device (LVAD), or mechanical pump, “also known as a ‘bridge to transplant,’ which has improved to the point where it may sometimes take the place of a transplant itself.”  This battery-driven device preserves blood flow – something a healthy heart would do – to the kidneys, liver, and brain, as the patient waits for his new heart. Cheney received one of these in 2010, Dr. Siegel reports, “and his health appeared to improve almost immediately.”

The LVAD is no longer just a bridge, Siegel explains. “It has evolved to the point where it can shore up an ailing heart and keep a patient alive indefinitely. In . . .Cheney’s case, it is almost as much of a miracle as the transplant itself,” he writes.

Over 2,000 heart transplants were performed in 2009, the last year for which statistics are available, according to The Web site also reveals that almost 75 percent of heart transplant patients are male, almost 70 percent, Caucasian, and more than half are age 50 or older. Globally, 800,000 people are waiting for a new heart.

Like all heart transplant patients, Cheney will be monitored for infection, bleeding, blood clot, or stroke, and if all goes well, will be allowed to go home in a few weeks, according to Dr. Siegel. But he will have to take strong anti-rejection drugs for the rest of his life so his body does not reject the heart.

Siegel cautions that, even with these drugs, “over half of heart transplant recipients are faced with at least one episode of rejection in their lives.”

According to Siegel, a New England Journal of Medicine study in 1994 found that patients least likely to reject a transplant are those are human-leukocyte-antigen-compatible.  Seven percent of patients suffer kidney failure, due to the drugs.

Other problems transplant patients face include “plaques forming at an accelerated rate in the “new” coronary arteries and risk of malignancy from the anti-rejection drugs,” according to Siegel.  A careful diet, statin drugs and regular exercise are also mandatory.

The LVAD is no longer just a bridge to transplant. It has evolved to the point where it can shore up an ailing heart and keep a patient alive indefinitely. In former Cheney’s case, it is almost as much of a miracle as the transplant itself.

Edited by Jennifer Russell
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