Six months downrange from transplant: it seems like yesterday

June 8, 2013 was the day/night I hung up my LVAD and lost my bionic blood flow.  The HeartMate II LVAD kept me going for 38 months until a suitable donor heart could be found.  That is a miracle all by itself.  I had a few weeks to live in April, 2010, when the pump was implanted. 

It saved my life and I am grateful that the LVAD permitted me to wait and to receive a new heart.
Just in case, while I was at St. Mary's Hospital at Mayo Clinic, I wrote my obit.  That is harder than you might think.  It is what is called "a hold for release" obit, written in advance of the final event.

As my 30th month of LVAD living came, so did a driveline site infection.  The infection never completely healed.  At about 33 months after LVAD implant, clots began to develop in the pump.  The solution was to increase anti-coagulants.  The alternative was to exchange the HeartMate II.  The cardio team at the U of Minnesota opted for increasing anti-coagulant therapy.  Replacing the pump posed the risk of developing significant anti-bodies based on the transfusions needed for the operation.  More anti-bodies did not bode well for the likelihood of finding a donor heart match. The fewer significant anti-bodies a potential recipient has, the better chance for a donor match.

After the 38 months, I match was found and I'm here, upright and thriving.  There are some pitfalls. The one I deal with daily, for example, is the combination of drugs I take to minimize/manage potential rejection of the new heart by my immune system.  Getting the levels of the drugs in balance is a persistent pharmacological test for the cardio team.  It can take up to a year to get them in balance.

While the U.S. Food and Drug Administration has approved the HeartMate II for both "destination (no chance for transplant) therapy" and "bridge (transplant listed) therapy," some problems have developed in the clotting arena.  A recent study published in the on-line version of the New England Journal of Medicine showed that clotting in LVADS was occurring sooner than the initial trials disclosed.  Here is a link to the article http://www.medscape.com/viewarticle/815186.

The suspected causes of the clotting are the continuous flow of the LVAD, which can cause red blood cells to shear into pieces that can form clots, and the heat generated by the pump can cause clotting issues.

As I said, I am thankful for the miracle of medical technology that gave me three years to wait for a heart.  I am also thankful that I am no longer bionic.

Please remember those in need and become an organ donor.  Your gift could save a life.