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The Cutting Edge

Patient First to Bridge from Experimental Total Artificial Heart to Transplant

  SynCardia Total Artificial Heart
  Human Heart
  The SynCardia Total Artificial Heart (top) and
a human heart (bottom).
Image: Courtesy of SynCardia

A petite 44-year-old woman at UCLA was the first patient in the world to receive a successful heart transplant after “bridging” with an experimental Total Artificial Heart designed for smaller patients. The 50cc SynCardia temporary Total Artificial Heart is a smaller investigational version of the larger 70cc SynCardia heart, which was approved by the Food and Drug Administration (FDA) in 2004 for use in people awaiting a transplant, and has been used by more than 1,440 patients worldwide. The 50cc device is designed to be used by smaller patients — including most women, some men and many adolescents — with end-stage biventricular heart failure to provide mechanical support until a donor heart can be found.

Nemah Kahala, a wife and mother of five, was transferred to UCLA in March. She was suffering from restrictive heart muscle disease and in critical condition. Her heart failure was so advanced that repair surgery and other mechanical-assist devices could not help. Kahala was placed on a life-support system called extracorporeal membrane oxygenation, but this only works for about 10 days before a person’s organs begin to deteriorate. With the clock ticking, doctors needed to buy time by replacing Kahala’s failing heart with an artificial heart while she waited for a heart transplant. Her chest cavity was too small for her to receive the larger 70cc artificial heart. However, under a onetime emergency use permitted under FDA guidelines, her doctors were able to implant the experimental 50cc device.

“Mrs. Kahala’s condition was deteriorating so rapidly that she would have not survived while waiting for a transplant,” says Abbas Ardehali, MD (RES ’95, ’97), director of the UCLA Heart and Lung Transplant Program. “We were grateful to have this experimental technology available to save her life and help bridge her to a donor heart.”

Two weeks after the total artificial heart surgery, she was strong enough to be placed on the heart transplant list. After a week of waiting, a donor heart was found. “In addition to the high-tech medicine that kept her alive, Mrs. Kahala and her family have exemplified how a solid support system that includes loved ones and a compassionate medical team practicing what we at UCLA have termed ‘Relational Medicine’ plays an important role in surviving a medical crisis,” says Mario Deng, MD, medical director of the Advanced Heart Failure, Mechanical Circulatory Support and Heart Transplant Program at UCLA.

Kahala was discharged from UCLA on April 18, 2015. She is grateful to be home in Riverside with her family.

 





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