EDWARD LIN/Daily Bruin Senior Staff Waiting for a heart
transplant, 19-year-old John Aguilar plays games
on his laptop in his room in the UCLA Medical Center.
By Hemesh Patel and Kiyoshi
Tomono
Daily Bruin Senior Staff
John Aguilar, a 19-year-old college student, played the trumpet
and was a member of a mariachi band until his heart failed to fully
function on its own.
Aguilar was diagnosed with cardiomyopathy, a disease that
affects the heart muscle, in late March and is now hooked up to a
Thoratec machine that mechanically pumps the heart, making a
clicking sound with each beat.
“I’m waiting for a heart,” Aguilar said.
“It’s just weird that I’m waiting for a heart and
that my own doesn’t work ““ I can’t believe
I’m here.”
According to UCLA heart surgeons, 40,000 to 100,000 individuals
nationwide would benefit from a heart transplant, but only about
2,400 to 2,500 patients receive these life-saving operations each
year. With an average wait time for a heart transplant being one to
two years, 700 patients die annually.
But recent developments in science and medicine may change the
face of heart surgery in the future, including at UCLA, as new
technology provides a solution to the shortage of hearts available
and may decrease the waiting period for patients like Aguilar.
On July 2, the Jewish Hospital Heart and Lung Institute
performed the first implant of ABIOMED, Inc.’s AbioCor
Implantable Replacement Heart in Louisville, Ky.
The artificial heart weighs about two pounds and includes a
hydraulic pumping system driven by a motor. A small electronic
package implanted in the abdominal area monitors and controls the
heart rate.
About a month and a half after the first surgery, the patient,
59-year-old Robert Tools, said during a press conference that he
felt fine, though the heart “feels real heavy” and he
still had to get used to the whirring sound of the motor device,
according to The New York Times.
The company that developed the artificial titanium and plastic
heart also selected the UCLA Medical Center as one of its five
trial sites around the nation.
According to Edward Berger, vice president for strategic policy
and planning of ABIOMED, UCLA was chosen because it met the three
requirements: it is a well-affiliated university teaching hospital,
it has had much experience with implantable heart assistant
devices, and has received national recognition for its heart
transplant programs.
“ABIOMED, Inc. is extremely comfortable with the skills of
the surgery team and UCLA’s institutional commitment,”
Berger said.
 EDWARD LIN/Daily Bruin Senior Staff Hillel
Laks, director of UCLA’s heart transplant program, holds
an artificial heart, which consists of titanium and plastic parts.
With patients ranging in age from two weeks to 72 years, the UCLA
Medical Center’s heart transplant program is one of the
largest in the world, conducting more than 1,000 transplants since
the program began in 1984, according to hospital
representatives.
While details of the second surgery and the patients involved in
future trials are shrouded in secrecy, officials at UCLA say they
will be capable of performing the surgery in the next few
weeks.
Those at ABIOMED aren’t telling the public of surgery
times and places to protect the privacy of the patients and to
allow the surgeons to perform the operations without distractions,
company officials said.
“We’re very concerned about patient privacy and
confidentiality. One way to protect that is to not have hundreds of
cameras camped outside,” Berger said.
Participants of the study must be cardiac patients previously
deemed ineligible for a heart transplant and who are thought to be
in danger of dying within 30 days.
Hillel Laks, director of the UCLA heart transplant program, said
the hospital staff had prepared for the surgery by placing implants
in animals and human cadavers.
“UCLA performs over 100 heart transplants a year,”
Laks said. “The institutional review board has approved the
clinical trial, but there are still a few steps left in
training.”
Because of the trial’s early phase, little can be said
about the benefits and risks of the artificial heart.
“ABIOMED, Inc. is extraordinarily pleased with the first
trial,” Berger said. “But it’s only one patient,
and we need to repeat that experience.”
Before the company makes a proper assessment, it must study a
patient 60 days after he or she receives an artificial heart
transplant.
Laks speculates patients who undergo the transplant will be able
to continue a relatively normal life.
“They would be able to be active ““ I’m not
sure about really rigorous activity like running, but they would be
able to go walking or get into a pool,” Laks said.
According to Laks, side effects of the artificial heart include
an increased risk of infection because of the potential for blood
clots to form. For this reason, those who undergo this surgery must
take anticoagulants.
But because the artificial heart is not at risk for rejection by
the body, patients will not have to take immunosupressant
medications.
“One benefit of the new artificial heart is it would be
readily available. If someone is in danger of dying, they could get
a transplant electively,” Laks said.
“But there are ethical issues that will come up with in
terms of implanting a device with an unknown quality of life and
the possibility of people being solely kept alive by an artificial
heart,” he added.
For example, a patient implanted with an artificial heart who
later becomes brain damaged would still have a heart that continues
to mechanically pump away, regardless of the loss of neural
function.
“In these instances, we might have the heart turned off at
the patient’s family’s request,” Laks said.
Other sites named to conduct the trial operations of the
artificial hearts include hospitals in Boston, Philadelphia,
Louisville, Ky., and Houston.
Berger said the company has made a commitment to perform five
trial surgeries by the end of 2001 and 15 by the middle of
2002.
While the university waits to perform the first artificial heart
transplant, Aguilar, who is not a candidate for an artificial heart
but for a human organ, also continues to wait.
“They still haven’t told me how long I will have to
wait,” Aguilar said. “They can just call up here and
get me ready for surgery at any time.”