Q: Are heart transplants more common these days?
A: Yes, much more. From about 1970-1980 they were outlawed because no one survived them. But in the 1980s, we began to use Cyclosporine, which suppressed the immune system enough, but not too much, which had been the problem. Last year my hospital alone had 119 heart transplants—that's about one every three days. Another reason they're more commonplace is because people don't die suddenly anymore. With defibrillators and stents we can save people from dying right away of a heart attack, but they still have heart failure, and still might need a new heart.
Q: What is the success rate of a heart transplant?
A: It's astounding—a 75 percent survival rate for five years.
Q: Why is that?
A: A much improved early treatment of rejection.
Q: Why are doctors performing more heart transplants, rather than trying to fix a sick heart?
A: Fixing a sick heart often carries very high risks without measurable long-term benefits. Quality of life often remains poor. Transplants can be risky, but the long-term gain is great.
Q: Do you think a patient's attitude has a lot to do with their chances?
A: Absolutely. When your heart quits, it's like a Civil War.
The heart is a spiritual organ. It reveals what's going on in the soul. So when patients' hearts fail them, they feel they're unworthy. Like the their hearts have rejected them. I've seen grown men cry over this, askng "What did I do wrong?" So it's very important that they stay positive. Another concern is that people worry that they'll take on the characteristics of the donor—characteristics they may not like. And while I've seen personality changes in people who've had a heart transplant because they've just stared death in the face, I haven't seen a person undergo changes that they could attribute to the donor.
Q: Is there new technology that's helping increase the odds of survival even more?
A: The big issue is waiting for a heart. A lot of times people who wait are getting drugs that are helping the heart pump, but these drugs will also eventually make the heart burn out faster. But there are mechanical heart pumps that are a safer way to keep people alive. Right now they're mostly being used temporarily, but more and more are becoming permanent. Imagine the possibilities with that!