Feature story for The Memphis Daily News
Aug. 14, 2013
Transplant reversal gives Memphian healthy future
After her mother died of heart failure, Anissa Swanigan began experiencing rapid heartbeats and was told to chalk it up to anxiety. With a pregnancy a year later, she was told she had hypertrophic cardiomyopathy, a congenital disease that results in a thickening of the heart muscle.
“I could barely walk from my garage to the driveway. Things were bad,” she said.
In 2009, Swanigan had a right heart catheterization to determine how well the organ was performing. When the diagnosis came in, she said, she was “devastated, shocked. I tried not to think about it. You’re praying; you’re hoping that somebody made a mistake.”
She would need a heart transplant. A subsequent life-threatening liver disease would require a liver transplant as well.
The want of a second opinion took her to the Mayo Clinic. Since August 2012, Swanigan has been a regular visitor to the hospital in Rochester, Minn., and she has been living there since February.
To further complicate matters, Swanigan is “highly sensitized,” meaning antibodies in her body would fight certain proteins on the cell surfaces in the donor heart and rejection of that organ would almost be a given.
“Not everybody has significant antibodies to other people, but we can develop these kinds of antibodies, especially if we’ve had blood transfusions or in women that have had children, or sometimes we just don’t know why,” Richard Daly, cardiovascular surgeon and team lead on Swanigan’s surgery, said by phone. “Some people have antibodies to a large portion of the population, and when that occurs, if somebody has antibodies to 80 or 90 percent of the population then, of course, getting a donor is much, much more difficult.”
In any multiple organ transplantation involving the heart, it is the first to be transplanted, which reduces the amount of time the organ is outside of the body. To combat Swanigan’s sensitivity, however, the liver would be transplanted first in an effort to soak up and reduce the majority of the antibodies and mitigate the chance that her body would immediately reject the heart. It would be only the second time such a reversal of transplantation had ever been done; the first was at the Mayo Clinic in 2011.
On Mother’s Day weekend, a donor became available. A team of surgeons and nurses worked for 12 to 14 hours to complete the process . . . (read more)