Teen lives 118 days without a heart

[The Spartan]

The Link

Teen lives 118 days without a heart
Miami girl was kept alive by a blood-pumping device until her transplant
The Associated Press
updated 2:43 p.m. CT, Wed., Nov. 19, 2008
MIAMI - D'Zhana Simmons says she felt like a "fake person" for 118 days when she had no heart beating in her chest.

"But I know that I really was here," the 14-year-old said, "and I did live without a heart."

As she was being released Wednesday from a Miami hospital, the shy teen seemed in awe of what she's endured. Since July, she's had two heart transplants and survived with artificial heart pumps — but no heart — for four months between the transplants.

Last spring D'Zhana and her parents learned she had an enlarged heart that was too weak to sufficiently pump blood. They traveled from their home in Clinton, S.C. to Holtz Children's Hospital in Miami for a heart transplant.

But her new heart didn't work properly and could have ruptured so surgeons removed it two days later.

And they did something unusual, especially for a young patient: They replaced the heart with a pair of artificial pumping devices that kept blood flowing through her body until she could have a second transplant.

Dr. Peter Wearden, a cardiothoracic surgeon at Children's Hospital of Pittsburgh who works with the kind of pumps used in this case, said what the Miami medical team managed to do "is a big deal."

"For (more than) 100 days, there was no heart in this girl's body? That is pretty amazing," Wearden said.

The pumps, ventricular assist devices, are typically used with a heart still in place to help the chambers circulate blood. With D'Zhana's heart removed, doctors at Holtz Children's Hospital crafted substitute heart chambers using a fabric and connected these to the two pumps.

Although artificial hearts have been approved for adults, none has been federally approved for use in children. In general, there are fewer options for pediatric patients. That's because it's rarer for them to have these life-threatening conditions, so companies don't invest as much into technology that could help them, said Dr. Marco Ricci, director of pediatric cardiac surgery at the University of Miami.

He said this case demonstrates that doctors now have one more option.

"In the past, this situation could have been lethal," Ricci said.

And it nearly was. During the almost four months between her two transplants, D'Zhana wasn't able to breathe on her own half the time. She also had kidney and liver failure and gastrointestinal bleeding.

Taking a short stroll — when she felt up for it — required the help of four people, at least one of whom would steer the photocopier-sized machine that was the external part of the pumping devices.

When D'Zhana was stable enough for another operation, doctors did the second transplant on Oct. 29.


"I truly believe it's a miracle," said her mother, Twolla Anderson.

D'Zhana said now she's grateful for small things: She'll see her five siblings soon, and she can spend time outdoors.

"I'm glad I can walk without the machine," she said, her turquoise princess top covering most of the scars on her chest. After thanking the surgeons for helping her, D'Zhana began weeping.

Doctors say she'll be able to do most things that teens do, like attending school and going out with friends. She will be on lifelong medication to keep her body from rejecting the donated heart, and there's a 50-50 chance she'll need another transplant before she turns 30.

For now, though, D'Zhana is looking forward to celebrating another milestone. On Saturday, she turns 15 and plans to spend the day riding in a boat off Miami's coast.

Amazing. I'm still trying to gather up my jaw. To live for 4 months with no heart thanks to modern medical technology. I don't envy her by any stretch, but I can't help being amazed.

As a side note I just heard that the surgeon who performed the first American heart transplant passed away.

[Surlethe]

Wow. Not to inject a sour note into discussion, but I wonder if keeping her alive that way bankrupted her family.

[The Spartan]

Wow. Not to inject a sour note into discussion, but I wonder if keeping her alive that way bankrupted her family.

That was my first thought, too. Though, I suspect not given the amount of treatment she has recieved, which suggests to me that her family has adequate coverage, or near enough. At the same time, I wouldn't be surprised to find out otherwise.

I'm more concerned about her though, at this point. At this rate, she'll probably be lucky to live to middle age and she has to be on anti-rejection drugs for the rest of her life which introduce other fun things, like an increased chance of infection and illness. To say nothing of possibly needing another heart by the time she's thirty. I can't imagine what her insurance premiums will be even assuming she can get coverage.

[Broomstick]

15 years ago I met a man who lived with an artificial heart for 2 months before getting a transplant - and at the time he was 5 years post transplant so this was possible 20 years ago. It is remarkable, but not unprecedented. What is most unusual is that this is a pediatric patient.

Wow. Not to inject a sour note into discussion, but I wonder if keeping her alive that way bankrupted her family.

That was my first thought, too. Though, I suspect not given the amount of treatment she has recieved, which suggests to me that her family has adequate coverage, or near enough. At the same time, I wouldn't be surprised to find out otherwise.

As the device was not approved for use in pediatric patients it would be deemed experimental. With very, very rare exception experimental items ARE NOT COVERED by US health insurance, and most of the exceptions I'm aware of concern cancer clinical trials.

No, almost certainly this was not covered by insurance. Unless someone/some organization donated a hell of a lot her family is now bankrupt.

I'm more concerned about her though, at this point. At this rate, she'll probably be lucky to live to middle age and she has to be on anti-rejection drugs for the rest of her life which introduce other fun things, like an increased chance of infection and illness.

On the other hand, she could be dead and in the ground already. Gee - die in your teens, or extend your life to 30 or 40. Is the choice here not fairly obvious?

I've known several transplant recipients. Yes, they have a greater risk regarding infections, but it's not necessarily crippling. I know a man who has had two kidney transplants who owns a business and has face-to-face contact with the public every day and so far is going strong. This is a manageable problem in most instances.

To say nothing of possibly needing another heart by the time she's thirty.

There's a 50% chance she WON'T need a new heart by 30. While heart transplants tend to fail 15-20 years post-surgery they don't always, and being young, that's probably less likely to happen in her case than in an adult.

I can't imagine what her insurance premiums will be even assuming she can get coverage.

She will NEVER be able to purchase health insurance on the private market. Never. Either she will have to work for a big multi-national that can absorb her into their employee pool, or go on Medicaid/Medicare if she qualifies - she will get Medicaid or not depending on what state she is in (some have special programs for transplant recipients who can't otherwise get insurance - my state has one such that subsidizes the premiums to keep them affordable. Other states have nothing for such people). She will get Medicare ONLY if she is permanently disabled. If the transplant is successful, though, usually the patient does NOT qualify as disabled any longer.

[PainRack]

As the device was not approved for use in pediatric patients it would be deemed experimental. With very, very rare exception experimental items ARE NOT COVERED by US health insurance, and most of the exceptions I'm aware of concern cancer clinical trials.

No, almost certainly this was not covered by insurance. Unless someone/some organization donated a hell of a lot her family is now bankrupt.

Guinea pig anyone?
Its how the non rich get access to experimental and radical medical care.

[Broomstick]

The Shriner's hospitals do provide care free of charge to needy children, but there's no indication that the hospital in question is on of the Shriner's.

So... either that, or someone is funding experimental medicine. This isn't an inherently bad thing, although needless to say such needy people are very vulnerable and exploitation is a real concern.

[Singular Intellect]

I really wish we'd hurry the fuck up with genetic engineering and start having people give birth to healthy, non complicated children.

[Kanastrous]

I really wish we'd hurry the fuck up with genetic engineering and start having people give birth to healthy, non complicated children.

Won't happen if the fundies get their way.

[Singular Intellect]

I really wish we'd hurry the fuck up with genetic engineering and start having people give birth to healthy, non complicated children.

Won't happen if the fundies get their way.

Can't disagree there; one of the reasons I've joined Calgary's CFI group.

[The Spartan]

No, almost certainly this was not covered by insurance. Unless someone/some organization donated a hell of a lot her family is now bankrupt.

Well shit. I can't say I'm surprised but still.

On the other hand, she could be dead and in the ground already. Gee - die in your teens, or extend your life to 30 or 40. Is the choice here not fairly obvious?

Oh, I'm not saying she made a bad choice, only observing that she got a short stick.

I've known several transplant recipients. Yes, they have a greater risk regarding infections, but it's not necessarily crippling. I know a man who has had two kidney transplants who owns a business and has face-to-face contact with the public every day and so far is going strong. This is a manageable problem in most instances.

There's a 50% chance she WON'T need a new heart by 30. While heart transplants tend to fail 15-20 years post-surgery they don't always, and being young, that's probably less likely to happen in her case than in an adult.

Hmmm. I guess the problems are not quite as bad as I had heard.

She will NEVER be able to purchase health insurance on the private market. Never. Either she will have to work for a big multi-national that can absorb her into their employee pool, or go on Medicaid/Medicare if she qualifies - she will get Medicaid or not depending on what state she is in (some have special programs for transplant recipients who can't otherwise get insurance - my state has one such that subsidizes the premiums to keep them affordable. Other states have nothing for such people). She will get Medicare ONLY if she is permanently disabled. If the transplant is successful, though, usually the patient does NOT qualify as disabled any longer.

I hate hearing this kind of shit...

[Modax]

This is what really floors me

"I truly believe it's a miracle," said her mother, Twolla Anderson.

The hard work of doctors and engineers is what made this possible, not God!

[Kamakazie Sith]

This is what really floors me

"I truly believe it's a miracle," said her mother, Twolla Anderson.

The hard work of doctors and engineers is what made this possible, not God!

I know, but in their defense they did thank the doctors.

[PeZook]

It is a miracle. Of science!

Seriously. The kind of things we can do today would be considered downright fucking divine intervention just 100 years ago.

[Modax]

It is a miracle. Of science!

Seriously. The kind of things we can do today would be considered downright fucking divine intervention just 100 years ago.

Absolutely. But the term "scientific miracle" is an oxymoron. Science studies the natural, not the supernatural!

[Broomstick]

Wasn't it Clarke who said any sufficiently advanced technology is indistinguishable from magic?

When I say "scientific miracle" (which is a pretty damn rare event) I mean a very significant advance.

[Modax]

Wasn't it Clarke who said any sufficiently advanced technology is indistinguishable from magic? When I say "scientific miracle" (which is a pretty damn rare event) I mean a very significant advance.

Well, I'd say that things like traversable wormholes or magnetic monopoles, which are so hypothetical that we don't have the slightest idea how to go about building them, or even if they are actually possible, could be considered miraculous if only because we have no idea how they're made. The advances we're poised to make in the 21st century, like strong AI for instance, are amazing, but I wouldn't say their miraculous.

[Broomstick]

Maybe it's just that I don't shy away from the word "miracle" simply because of its religious origin. I have no problem with the idea that humanity today is capable of things that a mere century ago would have seemed magical or, indeed, miraculous without attributing divine intervention to such human accomplishments. But that's me.

I'll just finish up that two of the major problems with artificial hearts are 1) making a pump reliable enough to support human life and 2) blood clots - artificial hearts require high doses of blood thinners which leaves the patient vulnerable to hemorrhage (the article in the OP mentions gastrointestinal bleeding) as well as strokes from either bleeding or blood clots. The biggest obstacle isn't engineering a pump, it's making it function without the side effects killing the patient. Hence, they may be used to sustain life until a transplant, on a temporary basis, but not long term. Both the engineering and medical obstacles are being worked on, and the devices have gotten better, but no one is entirely satisfied with the results as of yet. Certainly the ventricular assist device (usually used to help an ailing heart rather than replace it) has been an enormous asset to medical science even if it's not a true replacement.