January 12, 2021

VUMC now leads world in heart transplantation

Vanderbilt University Medical Center performed more heart transplants in 2020 than any other center in the world — 124 adult hearts, 23 pediatric hearts and VUMC’s first heart-lung transplant since 2006.

Vanderbilt University Medical Center performed more heart transplants in 2020 than any other center in the world — 124 adult hearts, 23 pediatric hearts and VUMC’s first heart-lung transplant since 2006.

While a number of factors contributed to Vanderbilt’s record year, chief among them were the tireless efforts of a talented multidisciplinary team and the deployment of cutting-edge technologies that have expanded the donor pool and allowed access to more organs.

“Throughout a tumultuous 2020 our heart transplant teams continued their work with a laser-like focus to impact the lives of these patients. As a result, there are 148 children and adults who have the opportunity for a long and happy life. I am incredibly proud of every member of these teams for achieving such outstanding results,” said C. Wright Pinson, MBA, MD, Deputy CEO and Chief Health System Officer for VUMC.

The transplant teams include cardiologists and cardiac surgeons, intensivists, nurses, nurse practitioners, pharmacists, social workers, financial coordinators, nutritionists, organ procurement coordinators, preservationists, operating room staff, cardiac anesthesiologists and nurse anesthetists, among others, led on the adult side by Ashish Shah, MD, professor and chair of Cardiac Surgery; Kelly Schlendorf, MD, MHS, associate professor of Medicine and medical director of VUMC’s Adult Heart Transplant Program; and JoAnn Lindenfeld, MD, professor of Medicine and director of the section of Heart Failure and Transplantation; and on the pediatric side by David Bichell, MD, William S. Stoney Jr. Professor of Cardiac and Thoracic Surgery and chief of Pediatric Cardiac Surgery at Monroe Carell Jr. Children’s Hospital at Vanderbilt; and Debra Dodd, MD, professor of Pediatrics and medical director of the Pediatric Heart Transplant Program at Children’s Hospital.

“Ours is an amazing team of individuals who have accomplished something truly extraordinary during what has been a challenging and extraordinary year,” Schlendorf said. “I think we all have a lot to be proud of.”

In addition to people, innovation and technology have played key roles in the success of Vanderbilt’s heart transplant programs. In February 2020 the adult team used a novel organ preservation technique to transplant a heart from a donor who died from cardiac death (as opposed to brain death) for the first time in Tennessee. Hearts from these donors (often referred to as DCD) are anticipated to expand the donor pool by up to 30-40%.

In September 2020, the team performed the first dual heart-lung transplantation of a COVID-19 patient in the world.

And throughout the year, the team has continued to pioneer transplantation of hearts from hepatitis C-infected donors, another strategy that in the current era has significantly increased the number of transplantable organs.

“The Covid-19 pandemic forced our team to make difficult choices about heart transplantation as a priority,” Shah said. “With each challenge, this team, along with VUMC senior leadership, found innovative solutions to allow for safe transplantation. While the overall volume of cases is gratifying, the heroic efforts to save lives and protect our clinical teams is the real achievement.”

In addition to the 23 pediatric heart transplants, the pediatric heart team placed ventricular assist devices in six patients, including in five infants less than 1 year old, Dodd said.

“Mechanical circulatory support in this young age group has been classically very difficult compared to other age groups, but we have had excellent success bridging our sickest infants to transplant,” she said.

The combined adult and pediatric transplant teams care for more than 600 transplant recipients as well as multiple individuals with advanced heart disease who are on the heart transplant waitlist. In addition, many patients are evaluated for newly approved therapies or considered for new and promising experimental therapies for advanced heart failure.

The Vanderbilt Transplant Center is part of an elite group of heart transplant programs that have performed nearly 1,500 transplants. The center’s adult heart transplant program began in 1985, followed by the opening of the pediatric program in 1987.

“This program exemplifies the best of VUMC,” said Seth Karp, MD, H. William Scott Jr. Professor, director of the Vanderbilt Transplant Center and chair of the Section of Surgical Sciences. “World-class research and innovation are being used to directly benefit patients in our community and help others across the world use new techniques and technologies to help their patients.”