Prominent cardiologist Dr. Eric Topol said former Vice President Dick Cheney’s heart transplant operation over the weekend raises “ethical” questions about age and waiting lists as they relate to organ transplants.
“The heart transplant is a controversial issue from an ethical standpoint since the availability of donor hearts is so limited and the list of individuals awaiting a new heart greatly exceeding the supply,” Topol said in an email to the San Diego Union-Tribune. Topol is chief academic officer with Scripps Health in San Diego.
About 2,300 Americans receive heart transplants each year. Recipients are typically selected based on the amount of time they’ve been waiting, medical need and geographic location.
More than 3,100 Americans currently are waiting for a new heart, and about 330 die each year before one becomes available, the Associated Press reported.
“We do not know the circumstances that led to Mr. Cheney’s heart transplant,” Topol said. “Was he just waiting on the list and had a perfect match show up? Or did he have an urgent or emergency indication due to failure of his heart-assist device or acute deterioration of his own medical condition?”
A Cheney aide told NPR that the former vice president had been waiting 20 months.
Cheney’s operation shines a light on another issue related to organ transplants — age. Heart transplant recipients typically fall between the ages of 50 and 64, but Cheney is 71.
The older a patient, the more toll a transplant operation takes on their body, typically. Plus, older patients aren’t likely to live as long with a donor organ as younger patients are.
“Patients over age 70 overall have a less favorable outcome after transplants,” Topol said. “Also, with [Cheney's] prior open-heart surgery many years ago, he would have considerable scar tissue that makes the transplant operation more challenging.”
However, as people live longer and stay healthier longer, it’s possible that the upper limit in the optimal age range for transplants will climb.
Cheney, who had severe congestive heart failure and has suffered five heart attacks over the past 25 years, certainly faces challenges on his road to recovery. He’ll likely stay in the hospital for a few weeks before beginning rehabilitation. The biggest threats he faces are rejection and infection.
Topol said he will not and has not “passed any judgment” about Cheney’s transplant, and the cardiologist said he hopes Cheney does “exceedingly well” in recovery.
By Brandon Glenn MedCity News
Brandon Glenn is the Ohio bureau chief for MedCity News.More posts by Author
Could be the VP received an "older" organ. Meaning the heart came from a much older donor (55 yrs & older). Those who agree to accept an "older organ" usually do not have to wait or wait as long.
I hope the Donor was an older person like mine was. It is not fair if it was a young person Heart, they belong to the young people.
I don't see an issue with age for any transplant. It is up to the physician team of the individual patient, not anyone else, to make that decision (and there are already guidelines in place that the medical community uses to determine good candidates for any individual organ). Life is no less precious at 90 than it is at 20 and we should all believe in fighting to do all we can to save anyone. We should all be very scared that Cheney's operation is being called into question at all- do you want the court of public opinion to decide if your life is worth saving?
One has to be careful about unintended consequences. For example, a fellow with a history of heart problems who is now 71 - if that age works against a transplant then maybe he would have been pressed to have a transplant 6 years ago. The statement that he was on the waiting list for 20 months on one hand seems to illustrate that no special consideration was given. On the other hand was there a more eligible patient who has been on the list for six months who might have to wait until sine months before getting a heart? It sounds cold and brutal, but basing heart transplants on price is at least an open above board way to handle the rationing that is needed. As soon as you use other techniques, techniques that on the surface are designed to be "fairer" or "moral", other issues arise and people are certain that what is most important is your celebrity status, position in life, who your brother-in-law is and the like.