Developments making a difference in cardiac care

It’s been over 50 years since the first U.S. heart transplant was performed — by Dr. Norman Shumway at Stanford University. That first patient survived just 15 days.

Today, heart transplant recipients live for decades with their new hearts, thanks to advances in transplant science, antirejection drugs and post-transplant rehabilitation. Better therapies for patients’ non-cardiac medical conditions have also contributed to improvements in outcomes.

Sharp Memorial Hospital was the first in San Diego to transplant a human heart successfully, on Oct. 11, 1985. Today, Sharp Memorial is recognized as a global leader in heart transplantation for its innovation and success. Sharp doctors have performed more than 500 heart transplants in the last 38 years, and Sharp Memorial has one of the country’s highest long-term survival rates.

Dr. Brian Jaski, a cardiologist affiliated with Sharp Memorial and Sharp Community Medical Group, is a heart failure specialist who has been with the heart transplant team since its inception. Here, he answers questions about some of the recent developments in cardiac care.

What innovations have made a difference in cardiac care?
One of the biggest innovations in care for advanced heart failure has been the very reliable left ventricle assist device (LVAD). This is an implantable heart pump that helps weakened hearts push blood throughout the body.

Patients who receive LVADs return home to recover other organ function and strength while awaiting transplant, or they receive LVADs as an alternative to heart transplant. Some patients can remain on LVADs for decades, and LVADs are a life-extending option for patients who are not good candidates for a transplant.

Sharp has been a leader in this area of cardiac care. Sharp Memorial Hospital is often involved in national clinical trials for new LVAD technology because of the hospital’s expertise in the devices.

How can care providers detect a patient’s risk of heart transplant rejection?
The traditional way to test whether a body might reject a heart transplant is through examining samples of heart tissue taken from invasive biopsies. However, the new donor-derived cell-free DNA (ddcf-DNA) blood test offers a faster, more effective method to test whether a patient may have a heart transplant rejection.

This blood test can detect the breakdown of cells released from the donor’s heart and can catch signs of a heart transplant rejection several weeks earlier than a heart tissue biopsy. In the past, patients would need up to 12 biopsies within the first two years of a transplant. This new blood test reduces the number of biopsies in the first year by half.

What roles does gene therapy play in treating heart failure?
Gene therapy supplements or corrects an insufficient or altered gene protein product that is contributing to a patient malady. There are already several types of gene therapy treatments for diseases that have been approved by the Federal Drug Administration (FDA).

Sharp and other medical centers are exploring an investigational gene therapy that could improve a heart failure patient’s heart function enough to avoid or delay progression to a need for an LVAD or heart transplant. Via this treatment, the patient would receive a one-time infusion of gene therapy into the blood vessels that feed the heart. Data in animals with heart failure has shown this gene therapy to improve heart function and survival.

Learn more about treatments for advanced heart failure at Sharp.

For the news media: To talk with Dr. Jaski about advances in cardiac care for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.