Dr. Mehmet Oz has performed hundreds of heart transplants from his hospital, New York Presbyterian, in Manhattan. Here, he sheds some light on the questions and concerns many have about heart transplants, and also talks about the urgent need for more donors.
Q: When is a heart transplant necessary?
A: A transplant is necessary when your heart has failed so badly that it's no longer able to pump blood throughout your body.
Q: Have you yourself performed heart transplant surgeries?
A: Yes. Hundreds.
Q: How long is the typical wait for a new heart?
A: It all depends on how sick you are. Those who are dying in the hospital, the sickest of the sick, have priority over those who can wait at home for a new heart. But it's a gamble. That person waiting at home could die suddenly as well. The problem is there are so few hearts to give. There are about 2,200 hearts donated every year, but that number has not gone up in over a decade. There's a scarcity in donors. It's a painful but true reality.
Q: What goes in to finding the perfect match?
A: The match is based on blood type. There are four blood types—O, A, B, and AB. If your blood type is AB, you're what's known as the "universal recipient," so you can receive a heart from a donor of any blood type. If your type is O, you're what's known as the "universal donor," so you can give a heart to anyone regardless of blood type. Also, the heart of the donor has to be close enough to your own heart's size, so the donor has to be within 20 percent of the weight of the recipient. But the problem isn't with blood type and weight; the problem is there are not enough donors.
Q: Why the reluctance to donate?
A: I don't think people see it from the perspective of the recipient. They don't realize that they might be in a car accident one day and that they could end up waiting for a heart. And that's what I wanted to do with Transplant!—flip it around and get people to appreciate being one of the recipients.
There are also ideas people get that prevent them from becoming donors. Like they think they won't be saved if a doctor sees that they're a donor. But that's not the case. And I think it's important for people to see the raw emotion of what it's like to wait for a heart.
Q: Are heart transplants more common these days?
A: Yes, much more. From about 1970-1980 they were outlawed because no one survived them. But in the 1980s, we began to use Cyclosporine, which suppressed the immune system enough, but not too much, which had been the problem. Last year my hospital alone had 119 heart transplants—that's about one every three days. Another reason they're more commonplace is because people don't die suddenly anymore. With defibrillators and stents we can save people from dying right away of a heart attack, but they still have heart failure, and still might need a new heart.
Q: What is the success rate of a heart transplant?
A: It's astounding—a 75 percent survival rate for five years.
Q: Why is that?
A: A much improved early treatment of rejection.
Q: Why are doctors performing more heart transplants, rather than trying to fix a sick heart?
A: Fixing a sick heart often carries very high risks without measurable long-term benefits. Quality of life often remains poor. Transplants can be risky, but the long-term gain is great.
Q: Do you think a patient's attitude has a lot to do with their chances?
A: Absolutely. When your heart quits, it's like a Civil War.
The heart is a spiritual organ. It reveals what's going on in the soul. So when patients' hearts fail them, they feel they're unworthy. Like the their hearts have rejected them. I've seen grown men cry over this, askng "What did I do wrong?" So it's very important that they stay positive. Another concern is that people worry that they'll take on the characteristics of the donor—characteristics they may not like. And while I've seen personality changes in people who've had a heart transplant because they've just stared death in the face, I haven't seen a person undergo changes that they could attribute to the donor.
Q: Is there new technology that's helping increase the odds of survival even more?
A: The big issue is waiting for a heart. A lot of times people who wait are getting drugs that are helping the heart pump, but these drugs will also eventually make the heart burn out faster. But there are mechanical heart pumps that are a safer way to keep people alive. Right now they're mostly being used temporarily, but more and more are becoming permanent. Imagine the possibilities with that!