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Welcome to the INTEGRIS Baptist Medical Center’s Nazih Zuhdi Transplant Institute (NZTI) Heart Transplant Program Web site. As you can see from the timeline below, the Heart Transplant Program at NZTI represents a culmination of important events integral to the history of open-heart surgery and heart transplantation as reflected in our excellent outcomes.
HISTORY
- 1950’s: Drs. Zuhdi, Barnard, Shumway and others train under Dr. Walter Lillehei at University of Minnesota. Dr. Shumway later pioneers research in heart transplantation and develops heart transplant surgical technique in dogs at Stanford.
- 1960: Dr. Zuhdi performs the worlds first cardiac surgery using total intentional hemodilution: a technique of using cardiopulmonary bypass that revolutionizes cardiac surgery.
- 1967: Dr. Christiaan Barnard performs the worlds first successful heart transplant.
- 1968: Dr. Norman Shumway performs the first successful American heart transplant.
- 1982: Dr. David Nelson becomes first American heart lung transplant fellow at Stanford under Dr. Norman Shumway.
- 1985: Heart surgery pioneer Dr. Nazih Zuhdi and Dr. Christiaan Barnard start heart transplant program at Baptist Medical Center. Dr. Zuhdi performs Oklahoma’s first heart transplant March 5, 1985.
- 1994: Dr. David Nelson becomes Chief of the Heart Transplant Medicine Division at NZTI thereby joining for the first time the combined heart transplant experience of the Shumway and Barnard teams under the leadership of Dr. Nazih Zuhdi.
- 1998: NZTI’s 1000th solid organ transplant is a successful heart transplant.
- 2002: NZTI Heart Transplant Program achieves 100% one year survival rate.
- 2007: NZTI’s 400th heart transplant is performed.
- 2008: Dr. James Long, internationally recognized artificial heart and assist device surgeon and past president of the American Society For Artificial Internal Organs (ASAIO) joins INTEGRIS NZTI.
OUTCOMES
One-year survival rates for heart transplantation at the Nazih Zuhdi Transplant Institute are about 90%. The program has performed over 400 heart transplants. Some recipients now in their 70’s and 80’s are 15 and 20 years post heart transplant. In 2002 the program set a benchmark by achieving a 100% one year survival rate.
EARLY REFERRAL BEST
Early referral for transplant evaluation allows for patient comorbidities to be evaluated and optimally managed well in advance of transplant and provides time for family education. Importantly, it provides them with a better opportunity for heart allocation once listed. Because of changes in UNOS heart allocation policy in 2006, it is crucial, when possible, to evaluate patients before they are high acuity so that all their high acuity time is spent actively wait-listed instead of undergoing transplant evaluation. Note that referral indications are not the same as transplant indications.
REFERRAL INDICATIONS
In the U.S., greater than 90% of patients receive their heart transplants for pump dysfunction, less than 5% for refractory angina/coronary anatomy and less than 1% for ventricular arrhythmias. Referral indications are:
- Pump dysfunction, critical coronary anatomy, arrhythmias or combination for which a reasonable likelihood of mortality is thought possible in the next two years.
- Ejection Fraction less than 35% with comorbidities that need evaluation.
- Class IV symptoms
- VO2<15
- Refractory angina/critical coronary anatomy: inoperable on optimal therapy with risk/benefit favoring transplant over non-transplant in context of coronary anatomy, coexisting pump dysfunction and valvular disease.
- Life threatening ventricular arrhythmias for whom transplant represents a survival advantage determined by an electrophysiologist.
CONTRAINDICATIONS
The only absolute contraindication to transplant at our facility is HIV infection and this is subject to change pending results of NIH studies currently in progress. A history of previous malignancy will be assessed to determine the likelihood of recurrence post-transplant and certain current malignancies are assessed for compatibility with pre-transplant or early post-transplant treatment (such as some skin cancers and low grade prostate cancer). Risk factors for heart transplant outcomes such as age, diabetes, pulmonary hypertension, obesity, hepatitis, renal disease and lung disease are all assessed to determine the net burden of risk that they represent in the individual patient. Patients not qualifying for transplantation because of extracardiac medical problems may be considered for destination (permanent) home therapy with implantation of a left ventricular assist device.
TO MAKE REFERRAL
To make a referral for evaluation for heart transplantation call any of the numbers below:
- NZTI 24/7 main number is (405) 949-3349
- Daytime Week Day ask for Heart Transplant Intake Coordinator
- After hours, weekends and holidays ask for heart transplant coordinator on-call.
- Physicians feel free to page, Dr. David Nelson directly at (405) 629-3776, or call the NZTI main number (405) 949-3349.
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Nazih Zuhdi Transplant Institute
INTEGRIS Baptist
Medical Center
3300 N.W. Expressway
Oklahoma City, OK 73112
Main Number
(405) 949-3349 Toll-free
1 (800) 991-3349 |
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