In addition, Stanford Medicine surgeons performed 11 combined heart-lung transplants, increasing the total number of hearts transplanted to 103.² The program excels at multi-organ transplantation, performing the most heart-lung cases in the country.

"We continue to surpass our record volumes in heart transplants year after year," said Jeffrey Teuteberg, MD, section chief of Heart Failure, Cardiac Transplantation, and Mechanical Circulatory Support. "Exceeding 100 transplants is a significant milestone. The ability to perform more transplants than ever before is a result of our interdisciplinary team’s unwavering commitment to the program."

The team achieved the best transplant rate ratio for adult heart transplant programs in the United States.¹ Measuring observed-to-expected transplants, this ratio conveys the team’s ability to provide transplants to those in need in a timely manner. In fact, the time to heart transplant was shorter than the Donor Service Area, Region 5, and the national average.¹ Improved waitlist mortality rates accompany this success, falling lower than expected and national rates.¹

The program’s high organ offer acceptance ratio, which ranks best in California and second in the nation, made more transplants possible.¹ The organ offer acceptance rate also significantly exceeded expectations.¹ Stanford Medicine transplant surgeons use expanded eligibility criteria and apply advanced organ preservation techniques. This approach allows patients to get transplant surgery much sooner, sometimes within weeks.

"There are a lot of good organs that are not currently being transplanted," said Teuteberg. "Some centers may not accept a heart because it is farther away or from an older donor, but they are perfectly fine organs. We're expanding the pool by taking advantage of what’s there."

Over 50 years of heart transplantation and outcomes

In 1968, surgeons at Stanford Health Care performed the first adult heart transplant in the United States. A recent study from the Department of Cardiothoracic Surgery at Stanford School of Medicine characterizes how patient outcomes have changed over the past 50 years.

Led by Joseph Woo, MD, a professor and chair of the Department of Cardiothoracic Surgery, the study team analyzed over 2,600 patient records from 1968 to 2020. Stanford Medicine allowed for a comprehensive overview, with the largest heart transplant registry of any center.

Results revealed that long-term survival of Stanford Health Care heart transplant patients has improved over the years. Medical advances have likely contributed to long-term survival success, such as development in immunosuppression medications, organ donor procurement and preservation, and post-surgery care. On the other hand, this impressive trend occurred despite several challenges, such as increasing comorbidities and older donor and recipient ages.

"Stanford Health Care has a decades-long history of pioneering, leading, and advancing the field of cardiac transplantation," said Woo. "Patients who come to Stanford are often extremely sick and have complicated cases. Our outstanding surgeons, nurses, and other medical team members ensure that patients receive the highest quality care to facilitate a successful outcome."

Learn more about the study in European Heart Journal.

Innovative research strives to increase donor heart acceptance

Research at Stanford Medicine seeks to further expand access to heart transplantation. Kiran Kaur Khush, MD, a heart failure cardiologist and professor at Stanford Medicine, launched the largest-ever study to assess donor heart acceptance.

Khush recognized that an alarming 65% of donor hearts get discarded due to outdated acceptance criteria.³ Moreover, not all transplant centers follow the same criteria for deciding whether or not to accept a donor heart.

Over the past five years, Khush and her team enrolled nearly 4,500 heart transplant donors. The study had three primary aims:

•  Identify clinical measures of cardiac function in potential heart donors
• Prospectively study reasons for rejecting donor hearts
• Develop evidence-based, clinical guidelines for transplant centers to assess organ offers

Data analysis is currently underway, but the team's findings aim to establish reliable standards for transplant centers in the future. The data may also be used to develop tools for making real-time decisions about donor offers, such as a risk calculator.

"Hopefully, as our understanding of donor hearts grows, we can potentially offer more transplants to more patients," said Teuteberg. "It is fitting that Stanford led a national effort to study donor hearts, given Stanford’s history of pioneering work in the field of heart transplantation. Khush’s work will clearly advance the field and give more confidence and clarity to heart transplant centers when matching donors to patients."

Learn more about Stanford Medicine's Donor Heart Study.

Stanford Medicine professor receives lifetime achievement award

In another remarkable accomplishment of Stanford Medicine faculty, Hannah Valantine, MD, has been awarded the 2022 International Society for Heart and Lung Transplantation (ISHLT) Lifetime Achievement Award. Valantine, professor of cardiovascular medicine, is the third member of Stanford Medicine to receive this award.

ISHLT grants this honor annually to an individual with an unparalleled contribution or advancement within the field of advanced heart and lung disease. Recipients have distinguished themselves through a career of significant work toward improving patient care.

In addition to this prestigious ISHLT award, Valantine has received the 2022 Pamela S. Douglas Distinguished Award for Leadership in Diversity and Inclusion from the American College of Cardiology.

Extraordinary efforts to improve heart transplantation

Alongside Stanford Medicine scientists, Valantine collaborated in developing donor-derived cell-free DNA technology in heart transplantation, a novel tool used to monitor organ transplant rejection. Her research continues to establish this blood biomarker as a reliable indicator of allograft injury early, during acute rejection, and to help distinguish different types of rejection.

Results of her recent heart transplant study reveal that donor-derived cell-free DNA detects acute rejection earlier than the standard biopsy. Read the full article in Circulation.

The study came after initial findings from the Genomic Research Alliance for Transplantation (GRAfT) replicated the technology’s abilities. Created by Valantine, GRAfT is a consortium of five heart and lung transplant centers in Washington, D.C. GRAfT enrolls and actively follows transplant patients, almost half of whom are African Americans. The substantial inclusion of racial ethnic groups in GRAfT will allow for further studies by Valantine and her colleagues to understand why African Americans face a particularly high risk of organ rejection, with the goal of developing new anti-rejection drugs.

While at the NIH, Valantine was also a senior investigator of The Laboratory of Transplant Genomics which she established at the National Heart, Lung, and Blood Institute. Her efforts in team science, which brings together researchers from different fields to facilitate progress and innovation, have also been implemented at Stanford Medicine.

Heart transplantation at Stanford Health Care

Learn more about Stanford Health Care's Heart Transplant Program. The program continues to be recognized as a top-ranked heart transplant hospital for its high volumes, innovations, and expertise. Stanford Health Care is ranked among the nation's top 10 Cardiology & Heart Surgery programs four years in a row by U.S. News & World Report.⁴

Image of Joseph Woo, MD (left) and John W. MacArthur, MD (right), courtesy of Winston L. Trope

References:

1. Stanford Health Care Transplant Information. Transplant Program (Organ): Heart. Scientific Registry of Transplant Recipients. Accessed 10/25/2022.
2. Stanford Health Care Transplant Information. Transplant Program (Organ): Heart-Lung. Scientific Registry of Transplant Recipients. Accessed 10/25/2022.
3. Stanford Health Care. Donor Heart Study. Accessed 5/2/2022.
4. U.S. News Releases 2022-23 Best Hospitals Rankings. U.S. News & World Report. Accessed 10/25/2022.