Dr. William Hiesinger, section chief of Heart & Lung Transplantation and Mechanical Circulatory Support. Photo courtesy of Winston L. Trope.
Doctor Stories
For Top-Performing Heart Transplant Program, Innovation Is Key to Success
03.26.2024
The recently released biannual statistics from the Scientific Registry of Transplant Recipients (SRTR) has once again ranked Stanford Health Care’s Heart Transplant Program as one of the best in the country. The latest report (PDF), released in January 2024, provides data on heart transplant volumes and outcomes, and compares programs nationwide.
"We have a consistent track record of helping more patients receive a heart transplant faster and with exceptional results," says Jeffrey Teuteberg, MD, section chief of Heart Failure, Cardiac Transplantation, and Mechanical Circulatory Support.
Indeed, these SRTR performance metrics reflect the ongoing success of the Heart Transplant Program:
- Transplant rate: This metric has the highest impact on survival, according to the SRTR. Stanford Health Care’s observed transplant rate is the highest in California and Region 5 (California, Nevada, Utah, Arizona, and New Mexico), and is in the top 5 in the U.S.
- Time to transplant: The median time to transplant (0.6 months) is shorter than Region 5 (1.7 months) and the U.S. (3.4 months), putting Stanford Health Care in the top 5 in the country.
- Organ offer-acceptance ratio: Stanford Health Care offers a higher acceptance ratio (2.6) than Region 5 (1.3) and the U.S. (1.0), and is among the top 10 centers nationally.
- 1- and 3-year patient survival: Outcomes at 1- and 3-years post-transplant exceed national survival rates (1-year survival: 93.00% at Stanford Health Care vs. 91.57% in the U.S.; 3-year survival: 89.90% at Stanford Health Care vs. 85.92% in the U.S.).
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Jeffrey Teuteberg, MD
Advancing the field of heart transplantation
"Stanford Health Care has a long history of innovation, reaching back to 1968 when we performed the country’s first adult heart transplant," says Dr. Teuteberg. "We proudly continue that tradition of excellence with an emphasis on pioneering the latest discoveries to improve patient care."
Donor Heart Study: Improving heart transplant acceptance rates
Over one-third of eligible donor hearts are discarded each year. Stanford Health Care’s Donor Heart Study is helping decrease this waste and improve the pool of hearts available for transplant.
Funded by the National Institutes of Health, this prospective, multisite, observational study investigated the reasons why centers do not accept certain donor hearts. From 2015 to 2020, the research team, led by Stanford Medicine cardiologist Kiran Kaur Khush, MD, enrolled over 4,000 potential donors. They collected data related to donor evaluation and acceptance for heart transplant.
Recently published results from the Donor Heart Study are shedding new light on left ventricular (LV) dysfunction, which is often a reason for not accepting donor hearts. The researchers looked at echocardiogram-measured LV function following declaration of brain death and again after 24 hours. They also measured acceptance rates and post-transplant survival rates for hearts with varying LV function.
The results showed:
- 13% of donor hearts had LV dysfunction after brain death.
- Based on the second echocardiogram, LV dysfunction was reversible 58% of the time.
- The acceptance rate for donor hearts was 60% for hearts with normal LV function, 56% for hearts with reversible LV dysfunction, and 24% for hearts with nonreversible LV dysfunction.
- The 1-year survival rate after transplant was similar for hearts with normal LV function (91.3%), reversible LV dysfunction (90.1%), and nonreversible LV dysfunction (91.3%).
Kiran Kaur Khush, MD
"Heart transplant physicians can use these findings to guide donor evaluation and hopefully expand donor heart acceptance," says Dr. Khush.
Saving lives, one innovation at a time
The foundation for success at Stanford Health Care is constantly pushing the boundaries of science and adopting new technologies. Recent advances in heart transplant care at Stanford Health Care include:
- First successful transplant of a beating donor heart: Stopping the heart during the transplant process cuts off oxygen to the heart and can affect transplant success. A cardiothoracic surgical team, led by Joseph Woo, MD, Cardiothoracic Surgery Department chair, performed the first beating-heart transplant. The team is hopeful this new technique will improve patient outcomes.
- Noninvasive methods to detect transplant health: Transplant patients typically require invasive biopsies to assess the health of the transplanted heart. Researchers at Stanford Medicine have developed a blood test that uses cell-free DNA (cfDNA) to measure rejection. The test can also assess graft response to therapy, allowing a higher level of precision care. Patient monitoring using cfDNA is now a standard of care at Stanford Health Care.
- Technological advances in delivering donor hearts: New heart perfusion technology is helping Stanford Medicine physicians extend the time between harvest and transplant. Providing better perfusion over longer distances can help increase the donor pool and transplant rates.
Comprehensive cardiac care
In addition to the Heart Transplant Program, Stanford Health Care offers an Advanced Heart Failure Program that provides expert care for all causes, stages, and classes of heart failure. Heart failure clinics are available at multiple locations across the Bay Area, including Pleasanton, San Jose, and Stanford.
"Our specialists have extensive training in managing advanced heart failure," says Dr. Teuteberg. "We offer a complete range of treatment options, including medical therapies, implantable devices, surgery, access to novel technologies and trials, and heart transplant."
Learn more about Stanford Health Care’s Heart Transplant Program and Advanced Heart Failure Program.
About Stanford Health Care
Stanford Health Care seeks to heal humanity through science and compassion, one patient at a time, through its commitment to care, educate and discover. Stanford Health Care delivers clinical innovation across its inpatient services, specialty health centers, physician offices, virtual care offerings and health plan programs.
Stanford Health Care is part of Stanford Medicine, a leading academic health system that includes the Stanford University School of Medicine, Stanford Health Care, and Stanford Children’s Health, with Lucile Packard Children's Hospital. Stanford Medicine is renowned for breakthroughs in treating cancer, heart disease, brain disorders and surgical and medical conditions. For more information, visit: www.stanfordhealthcare.org.