Top Transplant Expert Shares Survival Info on HeartBrothers Foundation Webinar
Christian Jeeves lives with the question always in the back of his mind: How long will his wife Shalah, 37, live after her successful heart transplant six years ago?
“I won’t pretend that every day I don’t wonder what the future will hold,” he said.
Jeeves hosted a recent HeartBrothers Foundation webinar, “Long-Term Survival with Heart Transplant Patients,” which featured Dr. Amanda Vest, medical director of the Cardiac Transplantation Program at Tufts Medical Center. She addressed ways transplant patients can minimize complications and live a longer, healthier post-transplant life.
“This is a high priority in the heart transplant field,” Vest said. “How do we maintain the overall health of the patient at year five, 10, 15, and beyond? We have some new therapies and concepts that may be very useful going forward.”
Heart transplant patients—depending on how old they are when they receive their new hearts—can live 20 years and longer, Vest said.
In the first year after transplant, rejection is a fairly common problem. That’s when the body’s immune system fights the new heart.
“Fifteen percent of patients will experience some rejection in their first year,” Vest explained. “Signs and symptoms can include shortness of breath, fatigue, malaise, swelling in lower extremities, arrhythmias, lightheadedness. You always have to be vigilant for these symptoms of rejection.”
Rejection can be treated with immunosuppressants and steroids.
The problem is that those drugs can lead to several other health problems, including diabetes, obesity, hypertension, cancer, and infections.
“It’s a balancing act,” Vest said. “We try to find that sweet spot in the middle where we keep our rejection rates under control but also have the least long-term effects with malignancies.”
At five years post-transplant, doctors look for cardio-metabolic threats, including high cholesterol and blood pressure. “These are things a patient can absolutely do something about by eating healthy and exercising,” Vest said. Patients also begin regular screenings for cancer and kidney disease.
Coronary Artery Vasculopathy (CAV) is another common risk for heart transplant survivors.
CAV is a condition where the lining of the coronary veins thickens, restricting blood flow to the heart muscle.
One-third of transplant recipients will have CAV five years after transplant, and 50% at 10 years. Again, the key is controlling blood pressure and eating a balanced diet that is lighter on sugar and carbohydrates.
“Avoid red meats and prioritize fruits, vegetables, and lean meats, particularly fish. All those things are actions that can help protect the coronaries longer term.
“The healthier the diet the better we’re setting up the coronaries for success,” Vest continued. “A plant-based diet is a very worthwhile area to look at, a very worthy direction.”
Many transplant patients will take aspirin and a statin to reduce CAV.
Jeeves was upbeat after hearing the presentation. He and his wife are raising their three-year-old twins and looking forward to a long, happy life together.
“This has been quite a journey, an amazing experience, but not without a lot of heartache, stress, and family concern,” he said.
“Believe me, there is light at the end of the tunnel.”
To learn more about the HeartBrothers Foundation and all the ways it supports heart failure patients and their families, visit heartbrothers.org.