He lasted 2 months.
For reference, artificial hearts generally do 130 days -
(2018) https://syncardia.com/patients/media/blog/2018/08/seven-thin... with some notable outliers that live for years, and human to human transplant is about 9 years. Usually it's some related systemic problem that kills you under these conditions eg consistent brain clotting causing stroke or organ failure due to drug cocktails.
I found extra information for those curious about statistics involving human heart transplantation [1]:
"The most recent data of the registry of the International Society of Heart and Lung Transplantation indicates a current 1-year survival of 84.5% and a 5-year survival of 72.5%. This has significantly improved as compared to the 76.9% 1-year survival and 62.7% 5-year survival in the 1980s. The development of new immunosuppressive drugs which allow a variety of immunosuppressive regimens, tailored to the individual patient, has contributed to this success, since rejection and the adverse effects of immunosuppression could be better controlled. After 20 years, ca. 21% of patients are still alive, according to the international registry. In some experienced centers, long-term survival is reported to be even higher. The University Hospital Zurich has achieved a 20-year survival rate of 55.6%.
The improvement in outcome over the decades is related mainly to an increase in survival over the first year. After this period, the attrition rate of ca. 3-4% per year has remained similar over the different eras. This might be attributable to the fact that it was not possible to reduce the incidence of long-term complications after heart transplantation, such as chronic allograft vasculopathy (CAV) and malignancies, which account for ca. 35% of all deaths after 10 to 15 years."
The Wikipedia page cites a documentary as the source, which may be correct, but doesn't seem like an appropriate source. Here's a paper that I skimmed the abstract of claiming ~9 years:
Here's a 2015 article from the Journal of Thoratic Disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387387/.It doesn't calculate the exact average, but 21% of patients are alive after 20 years. Survival rates have definitely rapidly increased over the last two decades.
> Survival after heart transplantation is excellent, particularly if it is compared with the natural course of end-stage HF. The most recent data of the registry of the International Society of Heart and Lung Transplantation indicates a current 1-year survival of 84.5% and a 5-year survival of 72.5% (5). This has significantly improved as compared to the 76.9% 1-year survival and 62.7% 5-year survival in the 1980s. The development of new immunosuppressive drugs which allow a variety of immunosuppressive regimens, tailored to the individual patient, has contributed to this success, since rejection and the adverse effects of immunosuppression could be better controlled. After 20 years, ca. 21% of patients are still alive, according to the international registry (5). In some experienced centers, long-term survival is reported to be even higher (6-9). The University Hospital Zurich has achieved a 20-year survival rate of 55.6% (10).
>The improvement in outcome over the decades is related mainly to an increase in survival over the first year. After this period, the attrition rate of ca. 3-4% per year has remained similar over the different eras. This might be attributable to the fact that it was not possible to reduce the incidence of long-term complications after heart transplantation, such as chronic allograft vasculopathy (CAV) and malignancies, which account for ca. 35% of all deaths after 10 to 15 years (5).
To be honest, not sure why we spend so much resources on heart transplants. For the most part, the underlying condition that wrecked your old heart is probably still there. We should be putting more resources into preventative medicine.
This.
I know a doctor who was heading the liver transplant list.
Patients would come in, be diagnosed and told they need to live healthier, do this and do that as part of the preventative measures. Clear medical advice.
Habitual change is the hardest in my view and this is also how this story continues.
Over the course of time these patients will visit regularly. Their condition is worsening and the preventative medical advice will be stronger and more urgent.
In the end most still end in the transplant list. Most having exhibited little effort to turn their life around.
When it becomes evident that "clear medical advice" isn't working, then maybe we should dig another level deeper and find out WHY it isn't working. Shifting the blame to the patients when you have most that are failing is, in my opinion, bad medicine.
Artificial hearts are artificial hearts- mechanical plumbing. This is far more akin to human heart transplantation (which is a mature operation that has excellent outcomes).
It's still typically a massive change in quality of life. The left ventricle is what feeds your entire body blood; the right ventricle only feeds the lungs. When the left ventricle fails, blood backs up and starts overflowing into the lung space in addition to the rest of your body slowly suffocating. It's exceptionally unpleasant.
The right ventricle is usually in much better shape so an LVAD can be almost like having a functioning transplant, except that there's a big wire going out of your chest/neck (which is a constant infection risk and can't really get wet) and you're now battery-powered.
Any kind of heart transplant comes with huge problems, even besides the immunosupressants etc. The nerves don't reconnect, so the heart doesn't respond to commands to speed up. It makes any kind of exertion difficult and unpleasant. Diet is critical, clots are a constant fear, etc. By the time you get a transplant you've usually spent a while with insufficient bloodflow, and your organs have been slowly dying.
It's nothing short of incredible that people can get 20+ years out of transplants. The deck is stacked against us hard.
Artificial heart is kind of a non-specific term. It covers anything from LVAD, LBAD and RVAD together, ECMO or biventrivular vad. So depends on what you’re specifically referring to but lvad is the most common of those.
Fair enough. I'm in no way experienced in the medical field. I would have told you I thought an artificial heart was a complete heart replacement, just like a full transplant but with a mechanical device instead. TIL.
LVADs are implanted in your chest. Blood doesn't leave your body, but do they have external batteries. You have a wire coming out of your chest (or neck/head, sometimes) which is a constant infection worry. AFAIK the only external pumps are like, countertop kind of things.
They're ideally a stopgap, but even still it's typically a massive change in quality of life. The left ventricle is what feeds your entire body blood; the right ventricle only feeds the lungs. When the left ventricle fails, blood backs up and starts overflowing into the lung space. It's exceptionally unpleasant. The right ventricle is usually in much better shape so an LVAD can be almost like having a functioning transplant except for the risk of infection.
It is, and it has even been done. One large limitation is that it's not a great idea to have batteries inside the body. An LVAD is intrinsically liquid-cooled; batteries are not. Ruggedly encapsulating a battery means it is fairly well-insulated and can get warm. Batteries also fail pretty unpredictably- they're fundamentally dozens of square feet of very thin film, and it's very difficult to ensure that every battery is perfect. But again, it has been done.
Implanting a couple medium-size batteries and the circuitry+magnet for wireless charging is pretty robust to failure, but consider actually making that decision for yourself. You're already accepting huge restrictions, so is the wire that much of an extra burden?
Realistically, if the LVAD loses power, you're dead. It's not like suffocating; without bloodflow (even blood without oxygen!) your brain will die in about two minutes. Chest compressions probably won't even help. You got the LVAD because your heart couldn't pump, and chest compressions will not force blood through the LVAD. Even if this happens in the emergency room your odds are not good. Cutting open a chest to hand-crank a human is not easy. Pulling an ECMO machine and inserting the massive catheters is not easy. You might die while the machine is still rolling towards you.
... seems like a genetically-engineered pig's heart could avoid eventually be engineered to avoid some of those problems. It's science fiction, but quickly heading towards science, to engineer hearts which don't require quite the same cocktail of hearts. Cells would need to present the same way as the patient, so the engineering would need to be specific to each patient (which also means the patient needs to wait for the pig to grow old enough).
