THE ROAD TO 1,000 HEART TRANSPLANTS

While heart transplant procedures don’t make news the way they once did, Tyronne Baldwin’s marked an important milestone— the one thousandth heart transplant performed at Emory.

BY SHERRY BAKER • ILLUSTRATIONS PAUL OAKLEY

As the Douglasville, Georgia, resident is quick to point out, he feels great. “I’m 50 but I feel like I’m about 30 or 35 now.” His health and chances for an active life were very different in 2015, when he was diagnosed with heart failure and tests showed his heart’s ability to pump was failing dramatically.

Initially, Baldwin didn’t qualify for a heart transplant due to his weight. Tipping the scales at more than 300 pounds, and in no shape to exercise, he received an implanted left ventricular assist device, commonly known as an LVAD, to help his heart pump blood more effectively so he could undergo a gastric sleeve weight loss procedure.

By February 2021, he’d lost enough weight to be in Emory University Hospital, awaiting a heart. He exercised by walking the halls and spent time talking to and encouraging other heart patients who needed LVADs but were afraid of the surgery.

Baldwin received his new heart in May and was home three weeks later. He’s taking the year off to further recuperate, but he’s active and making plans for a future that just a few years ago didn’t seem possible.

“I’ve learned a lot about medicine from my experience. I previously worked in engineering, and the robotic aspect of this technology is intriguing,” he says. “I will also continue to speak up and urge people to become organ donors.”

Emory’s Heart Transplant Program is recognized as the foremost in the Southeast. No other heart transplant program in Georgia has done as many procedures as Emory’s. The story of Emory’s success in this life-saving field is far more complex than it may seem at first glance—and also more hopeful.

As Baldwin’s experience illustrates, the story behind each heart transplant involves an integrated team with multiple specialties, technological advances, and specialized patient care.

The path to Emory’s success in heart transplantation also points to the future of cardiology, with ongoing research into technologies that can help people awaiting heart transplants live better quality lives.

“I had a mentor in medical school who was a heart transplant surgeon and, very early on, he exposed me to the miracle that heart transplant really is,” says cardiothoracic surgeon Mani Daneshmand, director of the Emory Heart and Lung Transplantation program.

“A heart transplant is one of those few things that we as humans can do that so effectively and quickly impacts the lives of those around us for the better,” he says. “You take somebody who has less than a year or six months to live and who is miserable and you give them 15 to 20 years or more to live—good quality years. There’s really not anything else in society that can do something like that.”

The Beginning

The first heart transplant procedure took place more than a half a century ago. On December 3, 1967, 53-year-old Louis Washkansky received the first successful human heart transplant in Cape Town, South Africa. Because little was then known about how to suppress the immune system to prevent rejection, the surgery was a huge gamble and Washkansky survived only 18 days. By the l970s, the rejection problem proved daunting—too many patients were dying—and heart transplants were mostly stopped.

In the early l980s the drug cyclosporin, which lowers the odds of organ rejection and boosts survival rates, again made heart transplantation a potentially viable option for people with severe heart failure, sparking renewed interest and hope for the procedure in medical centers, including Emory University Hospital.

Douglas Murphy was a young Emory cardiothoracic surgeon in 1984 when he found himself at a meeting of senior surgeons discussing the launching of a heart transplant program at Emory University Hospital. Called away briefly to answer a page, Murphy returned to find he’d been chosen to be Emory’s new and, at the time, only heart transplant surgeon.

Murphy made arrangements to visit and observe surgeons with whom he’d trained who were then performing heart transplants at Stanford Univer- sity Hospital. “I went with them on the run to pick up a donor heart, watched the surgeons sew it in, and then came back to Emory and started organizing,” he recalls.

Emory’s heart transplant program began in 1985. In 2008, the hospital celebrated its 500th heart transplant. From 2008 to 2021, transplant surgeons completed an additional 500 transplants in just 13 years.

In 1985, a young man from South Carolina was in the hospital with severe heart failure. The newly launched Emory Heart Transplant team was notified of a donor heart in south Fulton County, Georgia. They rapidly retrieved the heart, and the transplant went well. And although the young man eventually suffered rejection of the heart, he received a second successful transplant at Emory. Other heart transplants followed, most with good outcomes.

Murphy is now medical director of surgical robotics at Emory Saint Joseph’s Hospital, but occasionally he still hears from former heart transplant patients, including his third, Harry Wuest, who is one of the longest living heart transplant patients in the world (see sidebar).

TODAY’S HEART TRANSPLANT TEAM

In recent years, the national one-year survival rate for heart transplant patients has climbed to 90 percent, according to Emory Clinical Chief of Cardiology Andrew Smith, a specialist in heart failure and transplantation cardiology. “At Emory, that survival rate is 94 percent. For each year after the first year, there is over a 96 percent chance of ongoing survival. So, the outcomes are very promising,” he says.

J. David Vega, current director of Emory University Hospital’s Heart Transplant Program, has performed more than half of Emory’s heart transplants. He credits collaboration for the remarkable success of Emory’s program. “We