Friday, June 13, 2008

Competing with new heart

We continue to hear amazing stories about how organ transplantation transforms our lives in so many ways. Nothing is more awe-inspiring than the stories of patients who were once very near death and our now competiitive athletes. The showcase for these remarkable people is the annual transplant games. For more info visit the following links: U.S. Transplant Games 2008 Pittsburgh July 11-16, 2008. Canadian Transplant Games Windsor, ON Aug 5-10, 2008.

Heart transplant recipient Brian Barndt, 40, of Wake Forest, right, competes in the Gary Kirby Triathlon for Cancer Research in Raleigh. He swam 300 yards before handing off to teammate Joe Cabaleiro, 51, of Cary, who also had a heart transplant. PHOTO BY COREY LOWENSTEIN

From The News-Observer in North Carolina:

By Joe Miller
RALEIGH, North Carolina - Joe and Mariella Cabaleiro and Caroline Barndt were reminiscing Saturday over the day they met three years ago in the cafeteria at UNC Hospitals. The discussion started over cookies, and then Mariella Cabaleiro asked, "So ... why are you here?"

Barndt's husband, Brian, was being evaluated to see whether he was healthy enough to undergo a heart transplant. Caroline was terrified. You can't imagine what this is like, she told the couple.

Actually, they could. Joe, trim and fit, had undergone a heart transplant the previous fall. Caroline was stunned.

"You don't look like you've had a transplant," she said. Imagine her reaction when the Cabaleiros told her that within a year of getting his new heart, Joe had ridden 64 miles on his bike. (Two months later he would do 100.)

"Brian's got to meet you," Caroline told Joe.

Brian Barndt was a competitive swimmer at UNC-Wilmington when he began having heart trouble in 1990, between his junior and senior years. Drugs controlled the situation for 10 years; then his heart began declining in earnest. He had a defibrillator implanted in 2001 and open-heart surgery to repair a valve in 2003.

When he met Joe Cabaleiro in July 2005, Barndt was clinging to life. Surviving, not swimming, topped his to-do list. "I can't allow myself to even think about swimming again," he told Cabaleiro.

"But you will," insisted Cabaleiro, who had become an avid volunteer with Carolina Donor Services, counseling folks such as Barndt.

Barndt smiled as the line was repeated Saturday morning. "Can you believe we've gone from the cafeteria to here?" he asked.

By "here" he meant at the finish of Saturday's Gary Kirby Triathlon for Cancer Research, where the two had just finished their second sprint triathlon together -- Cabaleiro biking 12 miles, Barndt swimming 300 yards.

Three hundred yards he couldn't have imagined three years earlier.

Overcoming obstacles

The idea of transplanting organs from one human to another dates to the late 1700s, but it wasn't until Dec. 3, 1967, that a heart from one human, a 24-year-old woman who was struck by a car and declared brain dead, was transplanted into another human, 55-year-old Louis Washkansky, who was suffering from chronic heart disease.

That Washkansky managed to live for 18 days with someone else's heart beating inside him was considered a resounding success. Within the next year, 100 more heart transplants would be performed.

By 1970, though, the number had dropped to 18 because so many patients were dying shortly after surgery. The reason: the human immune system's natural tendency to reject foreign objects.

"They kind of went on a break in the 1970s," UNC heart surgeon Dr. Chris Selzman says of heart transplants. Medical science had figured out the harvesting and the suturing; next it had to learn how to trick the body into accepting an outside organ.

"They finally got a handle on rejection with the development of cyclosporine," Selzman says. The drug is used in transplants to relax the immune system and make the body more receptive to a new organ.

Heart transplants are still considered a treatment of last resort, after drugs and lesser surgical options (bypasses, valve replacements) have been exhausted. Only about 2,000 are done each year.

While there are still complications -- the relaxed immune system, for instance, means organ-transplant recipients are more vulnerable to a variety of viral threats -- a heart transplant not only means the opportunity to keep living, but to keep living with a quality of life unimaginable to Louis Washkansky. Read the full article.

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