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U's heart transplant program celebrates 30 years

For cardiothoracic surgeon Lyle Joyce, M.D., Ph.D., it’s still a vivid memory. As a surgical resident at the University of Minnesota in 1978, he scrubbed in with Demetre Nicoloff, M.D., Ph.D., and William Lindsay, M.D., to perform Minnesota’s first heart transplant.

The world’s first heart transplant had been done about a decade earlier in South Africa by Christiaan Barnard, M.D., who trained under University surgery legends Owen Wangensteen, M.D., Ph.D., and C. Walton Lillehei, M.D., Ph.D. But in the late 1960s, those who survived the surgery eventually died when their bodies rejected their new hearts.

By 1978, Joyce says, better immunosuppressive drugs had become available. Though the new drugs were effective in people who’d had kidney transplants, doctors didn’t know whether they would work in heart transplant patients.

The University’s pioneering surgical team decided to find out.

“There was a certain sense of experiencing a miracle when I saw the empty chest be filled by a completely still donor organ that spontaneously started beating once it was sewn in and received blood,” says Joyce, now a professor of surgery at the University. “Strange as it may seem, I still have the same sense of awe during each heart transplant, even after 30 years and hundreds of transplants.”

Evelyn Ryan's heart transplant in 2004 was the University's 500th. In June, she joined the ceremonial groundbreaking for the new University of Minnesota Children's Hospital, facility. (Photo: Willete Photo Works)

More Minnesota milestones

Antirejection drugs continued to improve, and in 1986 University surgeons performed Minnesota’s first heart-lung transplant, and a year later, the state’s first heart-kidney transplant. The world’s longest-living heart transplant survivor—now almost 28 years post-transplant—received her new heart here.

Today more than 650 heart transplants have been performed at the University’s hospitals. Sixty of those have been pediatric heart transplants.

The Ryan family of St. Paul knows the program’s success well—they live it every day. Before Dennis and Ing-Mari Ryan’s daughter Evelyn was born, doctors discovered that she had a complex congenital heart defect. After other interventions failed, Dennis and Ing-Mari knew a heart transplant would likely be the next step.

Evelyn had been on the transplant waiting list for two-and-a-half years when the Ryans got the call. On February 17, 2004, Evelyn received her new heart at University of Minnesota Children’s Hospital, Fairview. That day the 4-year-old also became part of history: Her heart transplant was the University’s 500th.

“We now celebrate Evelyn’s heart day much like we celebrate her birthday—with a special meal but also recognition of her donor family,” Ing-Mari says.

The next wave

Leaders of the University’s heart transplant program are proud of their many firsts. But today they have a new goal: preventing the need for transplants altogether. There just aren’t enough donor organs for everyone who needs them, says Daniel J. Garry, M.D., Ph.D., director of the cardiology division in the Medical School’s Department of Medicine and head of the Lillehei Heart Institute.

“The program today is focusing on innovation,” Garry says. “What can we do for patients who can’t get a heart?”

They’re finding answers on many fronts: building better, more durable devices that help prolong life for people in heart failure who aren’t eligible for a transplant and that improve quality of life for those waiting for a new heart; implanting ventricular assist devices that take over the work of a failing heart; and exploring ways to use cell therapy to prevent heart failure or to promote regeneration after heart damage.

And for those who still need heart transplants, they are working to develop new immunosuppressive drugs with fewer side effects, a better donor-recipient matching system, and a less invasive way to detect evidence of organ rejection.

Meanwhile, 8-year-old Evelyn Ryan is doing ballet and is eager to learn to play the piano. Now four years post-transplant, she loves singing, reading, and annoying her siblings.

“Evelyn approaches everything she does with incredible passion,” Ing-Mari says. “She adds a lot of fun and excitement to many, many people’s lives.”

By Nicole Endres

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