Valentine's Day is extra special for teen with new heart

Robin Wulffson MD's picture
heart transplant, Valentine's Day, hypoplastic left ventricle, rejection
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The concept of Valentine’s Day involves a heart; for Philadelphia high schooler, Brendan, the event brings to mind a new heart that he received two years ago. He has enjoyed good health now for about a year after suffering from a diseased heart and convalescing from transplant surgery. The 17-year-old heart recipient says, “To look at me, you would never know that I had a heart transplant, but if I am at the beach, there you go.”

Brendan’s problems surfaced shortly his birth in November. Despite living in a cool environment, he sweated constantly. At three months of age, he developed a chronic cough and contractions when he breathed. A heart murmur was detected at five months of age at a pediatric visit, which was at first shrugged off as an “innocent murmur.” However, it was the harbinger of a serious problem. An echocardiogram revealed Brendan had a hypoplastic (abnormally small) right ventricle. The right ventricle is responsible for circulating venous blood through the lungs for re-oxygenation; thus, its malfunction produced Brendan’s respiratory problems. His condition led to three open heart surgeries within the first 18 months of his life. He also had a pacemaker placed and did relatively well until age 12. During a family vacation to Disney World, he coughed up a cast, which is a rubbery structure formed inside the smaller breathing tubes within the lungs. His dad explained, “It looks like a gummy worm.” Brandon was then diagnosed with a condition known as plastic bronchitis. Since that episode Brendan recalls not being able to sleep at night because of coughing fits. He also continued to cough up casts. His doctors informed the family that the only remedy was a heart transplant.

At age 15, a donor heart was located and he underwent a heart transplant at Children’s Hospital of Philadelphia. The procedure was performed by a transplant team led by Dr. Thomas Spray. The surgery went well; however, during the first postoperative week, a severe bout of rejection arose. Brendan attributes his recovery from what was essentially a death sentences was the stepping up his medication regimen and a strong will to live. He remained hospitalized for seven-and-one-half weeks after the surgery. After he was discharged, he made weekly hospital visits.

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Currently, Brendan has a checkup every three months. He can now do just about everything any other kid his age can do, He can run a mile, but has no plans to prep for the Olympics. On a scale of 1 to 10, he places himself at a 7, compared to his classmates. He has plans to enroll in college after high school and is, understandably, considering a career in a healthcare profession, possibly nursing. He currently has no signs of rejection.

I came away from the interview with a strong impression that Brendan is a polite, well-balanced, and focused young man who is looking forward to a bright future for himself, which incorporates helping others. His story can be viewed at this link.

Heart transplantation was introduced as a clinical procedure more than 40 years ago. Since then, the number of heart transplants performed yearly in the United States has increased to an annual rate of well over 2,000. The procedure is now widely recognized as an effective therapeutic option for the treatment of end-stage heart disease. However, currently there are not enough organ donors to help every patient on the waiting list. At present, more than 4,000 individuals nationwide, including children, are on a wait list for a new heart.

A major problem of transplant surgery is rejection, a problem that Brendan experienced and fortunately overcame. In addition to improved medication regimens to combat rejection, technology is rapidly evolving. A recent advancement is the ability to transplant a warm, functioning organ rather than one chilled in an ice chest. It is made possible by the Organ Care System (OCS), which was developed by medical device company TransMedics. With the OCS, the heat is removed from a donor’s body and placed in a high-tech OCS box, where it is immediately revived to a warm, breathing state and perfused with oxygen and a special solution supplemented with packed red-blood cells. The device also features monitors that display how the heart is functioning during transport.

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