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Stanford Report, February 12, 2003

Reunion celebrates 35 years of heart transplantation at Stanford Hospital

By MICHELLE L. BRANDT

Joan Miller remembers when the Beatles came to town, but she says this was bigger. The longtime transplant coordinator uses the term "awe-inspiring" to describe the feeling of seeing "a heart put inside a chest for the first time" along with the rest of the craziness surrounding the country’s first heart transplant. Norman Shumway, MD, the Frances and Charles D. Field Professor of Cardiac Surgery, Emeritus, performed the procedure on Jan. 6, 1968.

Norman Shumway (left) chats with transplant recipient Michael Miraglia, who received a new heart here last year. The medical center, celebrating 35 years of heart transplantation, has one of the most successful programs in the world. Part of the festivities was marking another milestone: Shumway’s 80th birthday. PHOTO: JOHN SHERETZ

"The hospital walls were packed with journalists, and some people were climbing the walls outside to try and peek into the room," Miller recalled. "It was a long time before I actually saw a procedure because there were so many other people who wanted to watch."

Thirty-five years later, nearly 1,100 people have received heart transplants at Stanford — and many of the physicians and nurses, including Shumway and Miller, still work in the heart transplant program. On Feb. 5, a group of patients, faculty and staff gathered at the hospital to share their experiences and celebrate the anniversary of the program — one of the biggest in the country.

"You are so marvelous, so strong and so courageous," Shumway told the packed room of patients. "Everything we’ve done has been rewarded by your being here and greeting us tonight."

Few could argue that heart transplantation would be where it is today were it not for Shumway. "He is the father of the field, and without him and the work he did in the laboratory, the first transplant wouldn’t have happened when it did," said Bruce Reitz, MD, the Norman E. Shumway Professor in Cardiovascular Surgery and chair of cardiothoracic surgery.

In the 1950s and 1960s Shumway’s team developed procedures that made heart transplantation possible, mainly by transplanting hearts in dogs.

Shumway went on to perform scores of transplants following his first in 1968 and continued his work even after the American College of Cardiology recommended a moratorium on heart transplants — because of low survival rates — in the 1970s. At one point, his group was one of only two in the country performing the procedure. Shumway’s subsequent work with cyclosporine, an anti-rejection medication, helped dramatically improve outcomes for patients.

"Many people gave it up when they thought it was too difficult, but Dr. Shumway had the persistence and vision that it could work," said Reitz, who performed the world’s first successful heart-lung transplant with Shumway in 1981. "His determination to make heart transplantation work was absolutely crucial."

Shumway oversaw more than 800 transplants during his tenure as chair of cardiothoracic surgery from 1974 to 1992, and much changed during that period. While a two-week stay is common for today’s transplant patients, the earliest patients stayed in the hospital for as long as four months and were put in total sterile isolation and watched constantly while here. ("Nobody knew how long they’d live and we didn’t want to leave them alone," explained Miller.) Medications were toxic and less effective at controlling rejection — which contributed to the one-year survival rate of 25 percent. Today the survival rate is 84 percent.

Shumway credits the improvements to "things that were done right here" by his colleagues, and it is obvious when talking with him and others that there is tremendous respect and admiration among program faculty and staff.

"I believe this program has been so successful because of the tight collaborations among cardiologists, surgeons, basic scientists, immunologists, nurses and social workers," said Robert Robbins, MD, associate professor of cardiothoracic surgery and director of the Heart, Heart-Lung and Lung Transplant Program. "They’ve been united since the first transplant."

Robbins and his colleagues also speak highly of the patients, who spent time at the reunion thanking their surgeons, cardiologists and nurses; chatting with fellow survivors and singing "Happy Birthday" to Shumway, who turned 80 on Sunday. Robbins said the reunion, which is an annual event, gives physicians the opportunity to re-connect with the people they’ve helped.

"These patients were literally on death’s door (when we saw them) and we were able to give them a second life," he said. "The satisfaction from knowing that we’ve given patients a meaningful and productive life is the currency that keeps us going."




Annual transplant reunion highlights success stories (8/7/02)

Local transplant patient and wife reach out to inmate who received new heart (2/6/02)