Record growth in heart transplants at Yale

In 2018, the Yale New Haven Hospital Heart and Vascular Center (HVC) underwent tremendous growth due to the addition of new physicians, additional staff and expanded services.

Built on the outstanding efforts before, during, and after transplant by a multidisciplinary team that includes surgeons, cardiologists, nephrologists, nurses, transplant coordinators and more, Yale’s heart transplant program performed a record-breaking 30 heart transplants in 2018, exceeding the previous high mark of 19 transplants in 1991. This sets a new record for Connecticut, surpassing the previous mark of 21 held by Hartford Hospital.

Top-notch cardiac care is delivered by Yale Medicine’s Comprehensive Heart Failure Program, part of HVC.

"We provide the right top-tier clinical care, at the right time, for patients at any stage of heart failure," said Daniel Jacoby, MD, director of the Comprehensive Heart Failure Program and associate professor of medicine (cardiovascular medicine) at Yale School of Medicine. "As part of the program, we do all we can to get a patient back to their life and avoid a transplant. Unfortunately, due to disease progression, sometimes a heart transplant is needed. When that occurs, we have an expanded program with additional experience to get those patients successfully transplanted."

The heart transplant program at HVC displayed a 114 percent increase in activity from 2017 to 2018, the largest growth of any U.S. heart transplant program. In addition to performing more transplants, patients are performing better post-transplant. In 2018, Yale New Haven Hospital (YNHH) achieved a 100 percent survival rate for heart transplant recipients 30-days post-surgery. YNHH’s one-year survival rate for 2018 was 89.5 percent.

Last year, YNHH gained the added experience of a new transplant surgical lead enhancing our ability to expertly match donors with recipients, and expanding the ability to perform successful heart transplants in more patients. Additional physicians specialized in heart failure, nurses, and transplant coordinators also provide optimal care.

Achieving these outcomes speaks to the patient-centered care and dedication patients receive from our Yale Medicine and YNHH teams.

Dr. Eric Velazquez

Additionally, changes to the United Network for Organ Sharing’s organ allocation system have given YNHH increased access to organs that "we’ve been able to use for the sickest tiers of patients," explained Jacoby.

"These results would not be possible without the dedication and determination of our clinical and administrative teams," said Arnar Geirsson, MD, chief of the Division of Cardiac Surgery and associate professor of surgery in the Department of Surgery, and surgeon-in-chief of Cardiac Surgery, at HVC. "Patients seeking heart failure surgical treatments are particularly vulnerable, not only while waiting for and receiving treatment, but afterwards. The conscientious monitoring of this population requires countless hours and tremendous effort from extremely dedicated caregivers like those at YNHH."

Last year, HVC supported 37 patients with extracorporeal membrane oxygenation (ECMO) or temporary assist devices with a 49 percent survival rate.

"Patients who received ECMO were suffering from either cardiogenic shock or respiratory failure and were severely ill," said Ayyaz Ali, MD, surgical director of the Heart Transplant and Mechanical Circulatory Support Programs at YNHH and assistant professor of surgery (cardiac surgery) in the Department of Surgery at Yale School of Medicine. "We were able to provide life-saving treatment to these patients who would have not survived without temporary mechanical circulatory support."

In addition to ECMO, YNHH performed 31 left ventricular assist device (LVAD) implants to support patients awaiting a heart transplant. Four of these patients received a heart transplant last year.

"These patients received outstanding care from our pre-transplant and post-transplant teams, led by many physicians within the Section of Cardiovascular Medicine and the Department of Internal Medicine," said Eric Velazquez, MD, FACP, FACC, FASE, FAHA, physician-in-chief at the Heart and Vascular Center; Robert W. Berliner Professor of Medicine; and chief of Cardiovascular Medicine at Yale School of Medicine and Yale New Haven Hospital. "Achieving these outcomes speaks to the patient-centered care and dedication patients receive from our Yale Medicine and YNHH teams."

HVC is comprised of a multi-disciplinary team of experts in cardiovascular medicine, cardiac rehabilitation, cardiothoracic surgery, heart failure, peripheral vascular treatments, cardiovascular imaging, and vascular surgery.

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