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.