LCFC #16: Transplanting a transplanted heart

Plus: Heart rhythms and sleep, stress and sex and weightloss drugs

Hello to all my Lamb Chop fans,

I am back, after a little break, with what I hope will be some interesting heart tidbits and also stories to explore what it’s like to have a new heart.

One of those stories is about a random thought I had the other day, specifically could a transplanted heart be transplanted again? I took to PubMed, one of my favorite sites to find case studies and new research about the heart and found an interesting report published in May.

A team of doctors describe transplanting a donor heart into a 21-year-old man, who a day after surgery suffered a stroke. (Yes, typing that makes me uneasy given my surgery is still a bit fresh in my mind and probably also my husband’s and parents’, the only people to see me in the days after). The stroke was so bad it progressed to brain death, with the heart only suffering mild damage to the right ventricle. In turn, 10 days later the heart was transplanted again into a 63-year-old man. So far, at least 7 months after surgery, he has had no complications and his new heart is beating appropriately, the doctors write.

Though there’s a shortage of viable hearts, this transplant upon transplant hasn’t been tried often. The paper describes a case from 2010, which was successful, and cites a few others with mixed success, leading to the conclusion that this is an option to increase the donor pool but only in select cases, possibly for older adults who might be less likely to receive a transplant.

Also of the double transplants were done in men, which raises a question, along with a lot of other data, about availability of transplants for women, something I’ll get into in another newsletter. But speaking of sex, I did want to point to a study out yesterday showing differences in symptoms between men and women during cardiac arrest, when the heart suddenly stops beating, which is different from a heart attack, when blood is blocked from getting to the heart.

For men, the leading symptom of cardiac arrest was chest pain, for women it was shortness of breath. While the work is far from done, it is a step toward predicting cardiac arrest, something essential to saving the 90 percent of people who die if they suffer cardiac arrest outside of a hospital.

And while we are on women, men and the heart, there’s another study that shows 25 percent of women surveyed developed abnormal heart rhythms in their right atria, what’s called atrial fibrillation, after menopause and possibly due to stress and insomnia. What this research is arguing is that along with high blood pressure, obesity, type 2 diabetes and heart failure, stress and lack of sleep may also increase women’s risk of irregular heart rhythms. There are caveats, i.e. that this research was done based on survey results at a single point in time.

But, the results hint again at the heart-brain connection, which I find fascinating because we are not brain or body, but body and brain together. In that line, related to weight loss drugs in the news, my colleagues reported on what we know right now about the SELECT trial I mentioned earlier and also those same drugs and their effect on addiction, with another take on that here.

More next week.