DAVID GREENE, HOST:
And let's turn now to Dick Cheney. The former vice president is recovering from a heart transplant he received on Saturday at a hospital outside Washington, D.C. Cheney is one of the more than 2,000 Americans who get heart transplants each year. NPR's Rob Stein tells us more about this delicate procedure and also Cheney's prospects.
ROB STEIN, BYLINE: Heart transplantation has come a long way since Christiaan Barnard stitched the heart of a young woman into the chest of a middle-aged man in South Africa in 1967. He died 18 days later. Today, heart transplant recipients can expect to get a decade or more of life from their new hearts. Mariell Jessup is a heart expert at the University of Pennsylvania.
DR. MARIELL JESSUP: When patients are chosen carefully and they're in the care of a practiced transplant center, their outcomes can be truly remarkable.
STEIN: Few details about Cheney's case have been released. But heart transplant recipients are typically matched with donors with a similar body size and the same blood type. Hearts are in short supply and there's a long waiting list. So hearts generally go to the sickest person who's closest geographically and has been waiting the longest.
Mary Norine Walsh is the medical director of the heart transplant program at St. Vincent Heart Center in Indianapolis.
DR. MARY NORINE WALSH: These are all decisions that are made by experienced transplant cardiologists and surgeons, sometimes in the middle of the night on phone calls trying to make decisions for individual patients.
STEIN: In the Washington, D.C., area, the median waiting time is nine months. According to Chaney's staff, he waited 20 months. But the University of Pennsylvania's Jessup says most recipients are between the ages of 50 and 65. Cheney is 71.
JESSUP: In general once the patient is over 65 or 70 they become excluded from heart transplant.
STEIN: There are lots of reasons for that. One is that older patients are less likely to survive the operation, and more likely to die soon after even if they do.
Scott Silvestry is a transplant surgeon at Washington University in St. Louis.
DR. SCOTT SILVESTRY: More of these patients are more likely to die within the first 30 days than patients who are younger.
STEIN: Silvestry says heart transplant are especially difficult for patients like Cheney. Over his lifetime, Cheney had five heart attacks, one quadruple bypass, and several other heart operations.
SILVESTRY: You know, every time we go in an out of a person's chest, it makes the next operation slightly harder.
STEIN: Younger, healthier candidates are also more likely to get more years out of each heart. But Clyde Yancy, of Northwestern University, says there are no hard and fast rules.
DR. CLYDE YANCY: I think all of us would agree that there probably is not a hard stop; because you might find an especially fit and vigorous 70 year old, 71 year old that arguably would be a good candidate.
STEIN: One reason for that is people are living longer and staying healthier longer.
Again, Dr Walsh.
WALSH: Need is driving it dramatically. I mean the Baby Boomers coming into this age group are pushing the envelop on what therapies we now offer patients into their 70's.
STEIN: Some patients with severe heart failure are staying alive longer thanks to mechanical pumps like the one Cheney had implanted in 2010.
Savitri Fedson is at the University of Chicago.
DR. SAVITRI FEDSON: With the successes we have had with those, as I think most obviously evidenced by our former vice president, there are now increasing options for older patients who have terminal heart failure.
STEIN: But some question whether doing transplants on older patients is ethical. Robert Veatch is a Georgetown University bioethicist.
ROBERT VEATCH: Those of us who have been around for a long time, and I put myself in that category, need to step aside for younger people if there's a real scarcity of organs.
STEIN: Everyone agrees, that the older the patient, the harder the recovery. The first year after a transplant is often arduous and most fraught with danger. Rejection and infections are the biggest threats.
Cheney will probably be in the hospital for at least several weeks. Then he faces months of recovery and rehabilitation, and living the rest of his life on powerful anti-rejection drugs.
Rob Stein, NPR News.
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