Heart, Lung & Heart-Lung Transplant

Stanford has been recognized as the pioneering center for heart transplants. Dr. Norman Shumway and his colleagues developed the experimental basis for transplants in their early work, which then paved the way for the first adult heart transplant in the United States at Stanford in 1968. Since then, the Stanford team has come up with many innovations and continues to advance new techniques in surgery. The team has conducted more than 1,000 heart transplants.

In 1981, the first successful lung transplant was performed at Stanford by Dr. Bruce Reitz and his colleagues as a heart-lung transplant. This was made possible by the use of the immunosuppressive drug cyclosporine, and by previous laboratory research performed at Stanford. The team has been performing lung transplantation longer than anyone else and continues to make new advances. At Stanford, more than 150 patients have received a heart-lung transplant, and recently, over 120 patients have received either a single-lung or double-lung transplant.

Innovations, which have been introduced in the transplant field from Stanford, include:

• The operative method for heart transplantation
  
• The use of percutaneous, transvenous biopsy of the heart to detect rejection
  
• The use of new immunosuppressive drugs, including cyclosporine, for treatment of rejection
  
• The first successful heart-lung transplantation procedure
  
• The first successful use of a mechanical device or LVAD (left ventricular assist device) as a bridge to heart transplantation
  
• The first use of a living related donor for lung transplantation
  
• New methods for preserving the lung prior to transplantation and for detecting and treating rejection.
  

Heart transplant patients benefit from a cardiac transplant team consisting of dedicated transplant nurse coordinators, cardiac pathologists, and both pre- and postoperative transplant cardiologists. The lung transplant team comprises medical pulmonologists, surgeons, fellows, transplant nurse coordinators, and intensive-care nurses experienced in both heart and lung transplantation.

Approximately 40 to 50 patients undergo heart transplantation each year at Stanford, whereas an additional 12 to 20 patients receive some type of lung transplant. The procedures are performed in patients from newborns to adults over 60 years of age. Almost every type of end-stage heart disease has been treated, and the Stanford team remains a leader in introducing new concepts and treatments to improve the care of the transplant patient.