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Macomb County Man Receives Artificial Heart at Henry

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Macomb County Man Receives Artificial Heart at Henry henryford.com/transplant Trans 1-855-85-TRANSPLANT PUBLISHED BY HENRY FORDnotes TRANSPLANT INSTITUTE FALL 2019 MACOMB COUNTY MAN RECEIVES ARTIFICIAL HEART AT HENRY FORD HOSPITAL Johnnie Alexander, a 56-year-old Macomb County mechanisms are contained in an man, became the first successful recipient of an 18-pound pack that stays with the artificial heart at Henry Ford Hospital. “We literally patient. pulled him from death’s grip,” said Henry Ford Hospital Henry Ford Hospital’s multi- cardiothoracic surgeon Hassan Nemeh, M.D., who disciplinary Heart Failure Team performed the procedure. determined the FDA-approved The man suffered from cardiac sarcoidosis, a disease artificial heart was the only option that infiltrates organs of the body and causes abnormal left. The SynCardia Total Artificial inflammation and malfunction. Diagnosed with the Heart, which has been in use for Hassan W. Nemeh, M.D. condition more than three years ago, the patient eventually more than 32 years, replaces both suffered cardiomyopathy in both sides of his heart. failing heart ventricles and the four heart valves. Doctors were able to manage the condition with Data published in the New England Journal of Medicine medication, and the patient was placed on the transplant from the 10-year pivotal clinical study led to FDA- list in September 2017. But just after Thanksgiving 2017, approval; 79 percent of patients who received the Total Alexander’s heart started to fail despite treatments. Artificial Heart were bridged to transplant. The longest His Henry Ford Hospital medical team inserted a patient has been supported by the SynCardia Total an intra-aortic balloon pump, then a temporary left Artificial Heart is more than four years. ventricular assist device — or temporary LVAD — to Alexander and his wife agreed that he wanted to help his heart keep pumping. Both initially helped keep proceed. He received the artificial heart in a five-hour him alive. But then procedure that included a team of about a doctors discovered dozen medical professionals from the Henry his heart was again Ford Heart & Vascular Institute and the Henry malfunctioning despite Ford Transplant Institute. the interventions. “The operation went smoothly,” Dr. Nemeh The surgical team, said. “Due to the advanced level of illness, led by Dr. Nemeh, he progressed very slowly. But his general removed the patient’s condition is much, much better and we are native ventricles and grateful we were able to help him with this implanted the SynCardia advanced technology.” artificial heart on Dec. Pastor Alexander, who is also a retired law 11, 2017. The heart’s enforcement officer, returned to his church Hassan W. Nemeh, M.D. continued on page 2 PAGE 3 PAGE 5 PAGE 6 Effects Of Allocating Center for Living Increased Mortality Livers For Donation Rates in Heart Transplantation Transplant www.henryford.com/transplant 1-855-85-TRANSPLANT From The Editor MACOMB COUNTY MAN Welcome to the Fall 2019 issue RECEIVES ARTIFICIAL HEART continued from cover of TransNotes, a on March 18, 2018 and discussed the procedure and his wait for a heart newsletter produced by the Henry Ford transplant. Transplant Institute. Alexander spent months in the hospital and gained possibly 10-years Our purpose for to his life expectation. He’s not wasting time, Alexander is going back producing this to school to get a doctorate in theology and is contemplating a physical publication is to share therapy assistant program, too! “If we can save a life, I think we have our research and done a great job and a great justice to humanity,” he said. Alexander advances in the field Marwan S. Abouljoud, acknowledges his donor’s sacrifice and giving him life through the of transplantation with M.D., FACS heart donation, and a kidney to resolve his kidney disease. our colleagues. Henry Ford Health System is one of only three programs in the Moving into our 51st year, innovations in State of Michigan which provides comprehensive surgical therapy for the organ transplantation continue to advance treatment of advanced heart failure, including heart transplant, LVAD at Henry Ford Hospital. Henry Ford Hospital and the artificial heart. Cardiothoracic Surgeon Hassan Nemeh, M.D., successfully implanted the SynCardia artificial “Henry Ford Health System is proud to add the artificial heart as an heart on a 56-year-old Macomb County man, option for our patients,” said Henry Kim, M.D., head of the Edith and the only option left for this patient. Benson Ford Heart & Vascular Institute at Henry Ford Hospital. “It aligns We are also pleased to share growth in our perfectly with our emphasis on offering advanced treatments for all aspects VAD program which has surpassed national of heart disease.” one-year survival rates. Jennifer Cowger, M.D., To refer a heart failure patient or for more information, please call medical director of mechanical circulatory 1-877-434-7470. support, leads the VAD program. The Center for Living Donation is also working diligently to educate and recruit potential kidney and liver organ donations. With the work of Maria Zanini, clinical DIRECTOR ABOULJOUD manager, the Center has been able to reduce wait times from as long as five years to one to NAMED PRESIDENT-ELECT two months with living donations. Our team presented several oral and poster presentations at the American Transplant OF AMERICAN SOCIETY OF Congress last summer. Shunji Nagai, M.D., director, transplant surgery research, led many TRANSPLANT SURGEONS of the studies. We share these and others in this publication, as well as abstracts of During the 2019 American recently published research articles. Transplant Congress in Boston, Inserted in this edition of TransNotes is Marwan Abouljoud, M.D., FACS, a special edition of Where Miracles Happen. director of the Henry Ford Presented are the most recent data showing Transplant Institute was elected by our excellent clinical outcomes for each organ his peers as President-elect of the transplanted. We are always pleased to achieve American Society of Transplant Surgeons. He will officially assume these results, but continue to strive to advance the role of President of the organization during the 2020 Congress care on behalf of our patients. in Philadelphia. “I am honored to be chosen, particularly by my I hope you find these and the other colleagues, to lead this esteemed group,” said Dr. Abouljoud. articles informative and thought-provoking The Arlington, Virginia-based society represents approximately and perhaps valuable in your own research 1,800 surgeons and advances transplantation through excellence in or practice. As always, referring physicians should feel free to contact us at our toll- patient care, research, education and advocacy. “I hope to continue free number, 1-855-85-TRANSPLANT, or to the tradition of providing transplant surgeons the utmost support contact me directly at (313) 916-2941, for your now and in the future,” said Dr. Abouljoud. patient or practice needs. During his tenure, Dr. Abouljoud hopes to focus on surgeon Marwan S. Abouljoud, M.D., FACS assessment and certification process, increasing diversity in the Director, Henry Ford Transplant Institute workforce, and creating an effective wellness and resilience program. Benson Ford Chair Email: [email protected] 2 www.henryford.com/transplant 1-855-85-TRANSPLANT EFFECTS OF ALLOCATING LIVERS FOR TRANSPLANTATION BASED ON END-STAGE LIVER DISEASE MODEL (MELD) – SODIUM SCORES ON PATIENT OUTCOMES In January 2016, the Organ Procurement and The adjusted survival benefit of Transplantation Network/United Network for Organ transplant recipients vs. patients Sharing (OPTN/UNOS), introduced the Model for End-stage placed on the waitlist in the same Liver Disease and Sodium (MELD-Na) score for liver score categories was definitive for allocation. The effect of liver allocation based upon patients with MELD-Na scores of MELD-Na score for patients on waitlist (90-day investigation) 21–23 in the MELD-Na era (HR 0.336, and post-transplantation outcomes (1-year graft survival) P < .001) compared with MELD scores was evaluated. of 15–17 in the MELD era (HR 0.365, P < .001). Since 2002, the Model for End-stage Liver Disease Shunji Nagai, M.D., Ph.D. (MELD) score had been previously used for allocation of According to Shunji Nagai, M.D., Director, Transplant deceased donor liver grafts in the U.S. The MELD score was Ph.D., director, transplant surgery Surgery Research used to predict mortality in patients with liver cirrhosis research, the results of this study and it prioritized patients for liver transplantation (LT). indicate, “MELD-Na score-based allocation significantly However, hyponatremia, an independent prognostic factor decreased LT waitlist mortality. Hyponatremia was no in patients with cirrhosis, was not included in the original longer a risk factor for waitlist mortality and survival MELD score calculation. A proposed scoring system was benefit of liver transplant has successfully improved higher introduced to further decrease patient waitlist mortality scores and waitlist outcomes.” within a 90-day investigation by incorporating serum Nagai S*, Chau LC*, Schilke RE, Safwan M, Rizzari M, sodium concentration into the MELD equation (MELD-Na) Collins K, Yoshida A, Abouljoud MS, Moonka D. Effects and was officially implemented for liver allocation in 2016. of Allocating Livers for Transplantation Based on Model Two qualifying adult patient groups (≥ 18 years old) for End-Stage Liver Disease—Sodium Scores on Patient using retrospective data from the OPTN/UNOS registry Outcomes. Gastroenterology. 2018 Nov;155(5):1451-1462.e3. were examined; the MELD-period group composed of doi: 10.1053/j.gastro.2018.07.025. patients who were registered as transplant candidates www.ncbi.nlm.nih.gov/pubmed/30056096 from June 18, 2013 through January 10, 2016 (n = 18,850) Epub 2018 Jul 26. and the MELD-Na period group composed of patients *Shared authorship. who were registered from January 11, 2016 through September 30, 2017 (n = 14,512).
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