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Accounts of Two Heart Transplantation Patients

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发表于 5-17-2023 14:55:06 | 显示全部楼层 |阅读模式
(1) from one who was very dissatisfied, due to poor quality of life:

Alex Williams, Amy Silverstein, who chronicled a Life of Three Hearts, Dies at 59. New York Times, May 17, 2023, at page A21 (under obituaries).
https://www.nytimes.com/2023/05/ ... lverstein-dead.html

My comment:
(a) This article only says, "The cause [of death] was cancer," but does say what kind of cancer. This article says she had "multiple rounds of skin cancer,: In fact she also had breast cancer, followed by double mastectomy (removal of both breasts, often together with surrounding lymph nodes).
(b) The article also says she "was diagnosed with congestive heart failure," which required the first heart transplant. But "congestive heart failure" is only the (common) end stage of many (heart) diseases. I google and can not find the underlying disease she suffered (that led to congestive heart failure).
(c) The article says, "When her first donor heart succumbed to vasculopathy — vascular lesions that can be caused by some medications — she underwent a second transplant surgery in Los Angeles in 2014."
(i) Googling showed her first donor heart worked for 26 years before succumbing.
(ii) There are many kinds of vasculopathy (which is, in a word, sickness of vessels). The specific vasculopathy that is a complication of heart transplantation is Cardiac allograft vasculopathy (CAV).
Blood and Transplant, National Health Service (NHS), United Kingdom, undated.
https://www.nhsbt.nhs.uk/organ-t ... t-vasculopathy-cav/

National Health Service
https://en.wikipedia.org/wiki/National_Health_Service
(" Since 1948, they have been funded out of general taxation. * * * Everyone living in the UK can use the NHS without being asked to pay the full cost of the service, though NHS dentistry and optometry do have standard charges in each of the four national health services in the UK. In addition, most patients in England have to pay charges for prescriptions though some patients are exempted")  (footnote omitted)
(iii) The title of the article mentions "three hearts," which are the heart she was born with, along with two heart transplants (one after the other).

(d) "To check for signs of rejection, she had to undergo frequent heart biopsies in which doctors 'run a catheter down through your blood vessels and pluck pieces of your heart out,' Mr Silverstein [Amy's husband] said. 'She had over 90 of them.' "
(i) In heart transplantation, heart biopsy is done to detect the earliest sign of rejection in heart muscle, so that treatment (with anti-immune medications) can start at the earliest.
(ii) Heart biopsy is done, not by a needle through chest wall, but by a catheter that goes in through a nip in femoral vein (in groin) and up to heart -- or a nip in jugular vein (in the neck) and down to heart. Then a tiny clamp in the center of the catheter will make a tiny bite of heart muscle from within the heart.
(e)
(i) All transplantation patients need to take medications for the rest of their lives, to weaken their immune system and therefore reduce likelihood of rejection. The side effect is that these patients are prone to infections and cancers, for which these patients need to undergo screening for the rest of their lives.
(ii) In this use, "medication: (which can be singular or plural, depending on how many kinds) is the same as "medicine." (never plural, because it is a mass or uncountable noun).


(2) from one who is extremely satisfied:

Jason Gay, He Had a Heart Transplant. Now He's Back Playing College Lacrosse. Wall Street Journal, Apr 14, 2023.
https://www.wsj.com/articles/hea ... yan-scoble-10307ed9
https://hurstathletics.com/news/ ... -times-feature.aspx

Note:
(a) Jason Gay is a sportswriter with WSJ.
(b) This article sounds too good to be true. For one thing, during the surgery to transplant heart, the new heart lacks innervation from sympathetic and parasympathetic system because they are too small in diameters and too many to connect. For weeks after transplantation, patient can not rose abruptly (to prevent dizziness because not enough blood is pumped to brain), After two years, the reinnervation is only half way, and rigorous exercise is unlikely. A heart without nerve can still pump blood” when more blood comes ubto the heart, heart muscle is stretched, and the heart responded by pumping harder, to eject more blood.


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