I am proud of the program we built in Chicago, where we helped so many people — thanks to the tools I learned here — including saving two lives at the end of last year with back-to-back triple-organ transplants within 27 hours, a first in U.S. healthcare history. One of the patients, Sarah, was a 29-year-old woman who came to my office after multiple institutions told her she needed to go to hospice. I didn’t think so and said, “We’re going to try to do everything we can.” Sarah’s liver and kidney were destroyed by her heart failure, so she required a heart, liver, and kidney transplant. My team and I believed, “We can help patients even if they’re so sick.” While Sarah waited for her triple-organ transplant, a young guy, Daru — also 29 — was admitted with multiple organ failure. Everybody thought he was going to die. He had sarcoid disease, an inflammatory disease that affects multiple organs, and needed a triple-organ transplant. We were already in the mindset that we were ready to transplant Sarah, so we were going to help him too. Two days before Christmas, we did the triple-organ transplant for Daru, and while he was still in the operating room, matching organs came for Sarah. We accepted the offer and both patients received a heart, liver, and kidney before Christmas.
When Dr. Schwartz called me last November, shortly before the triple-organ transplant, I was doing clinical rounds. Dr. Schwartz has been a guiding force in my career, so whenever I see a call from him, I answer. I stepped into a quiet area. He said, “You’ve built a great program there, but it’s time to come home.” I knew he was right. It’s always hard to leave something you’ve built, but I believe that by returning to NewYork-Presbyterian I can have an even bigger impact and help many more patients and do something special here.
We began discussing our vision for enhancing and expanding the advanced heart failure and cardiac transplantation program at NewYork-Presbyterian. What amazed me when working here the first time is how NewYork-Presbyterian truly puts patients first. It’s all about the patients and what we can do to help them. It is wonderful to be back, the team has been so welcoming, including Dr. Bruce Lerman, chief of the Division of Cardiology and director of the Cardiac Electrophysiology Laboratory at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine, who also encouraged me to come back to NewYork-Presbyterian to continue my work and help build the heart failure program across the system.
Throughout my career, I have pushed the envelope to try to help patients. When you sit in front of a patient, you think of all the ways you can help them. Translational and clinical research — taking what you learn in the lab and applying it to medical problems — is one of the most important ways to make advances in the field of heart failure.
One of the aspects of research I’m doing with my team is to understand how we can improve the quality of life for those who need mechanical circulatory support — devices that help your heart function when it is not working at its best, including ventricular assist devices (VADs). When we implant these devices, we are creating something that is hybrid, half human and half machine, and this interaction between the machine and the human body, specifically in how it affects the blood, can be challenging. We have been studying and advancing ways to improve quality of life for patients who require these devices. My team and I slowly built a medical algorithm to advise how to treat these patients so the body will not be bothered so much by the presence of mechanical components inside of it. Our research focuses on the compatibility between the pump and the blood, and the potential adverse events associated with the technology and how to resolve them. As a result, I had the opportunity to be one of the national principal investigators of the biggest mechanical circulatory support study in history, MOMENTUM 3, which really changed the way patients receive therapy with mechanical support.
Side by side, I continue to study heart transplantation in general and high-risk heart transplant specifically. Heart transplant in HIV patients was the topic of one of my first papers, and it remains one of my biggest passions. Historically, HIV patients were excluded from heart transplantation when they reached the phase in which the heart was failing. But we started transplanting patients with HIV and learned that we can do it as successfully as those without it. Pooling our research, we published a few papers and were very proud that this helped change the guidelines. Today, HIV is not a contraindication to transplant anymore. We still call these patients high risk, but it’s something that we can do and help those patients.
Heart transplant is magical. The improvement to quality of life after heart transplant is amazing. And what I find even more amazing is the concept that people who just lost a loved one can help someone else. In their death, a person can help and cure another person.
You always want to be able to help your patient. You don’t want to say, “This is the end of the road.” Of course, there are patients you will not be able to help. But before we say no to someone, I think we always have to ask ourselves, are we really unable to help them?
I feel that it is the biggest privilege to help people in need. This is the thing that is most important — this is a person’s life.