A Deal Worth Making

Kerry Hayes was born with a heart murmur that never went away, the result of a faulty aortic valve. The murmur made him popular at his medical visits. “Every time I went to the doctor, they would have a crowd of people in to listen to it because the murmur was so pronounced,” says Hayes.
At age 47, after multiple open-heart surgeries, Hayes’ heart had deteriorated beyond repair. That’s when his doctors recommended that he be added to the heart transplant list at UW Medical Center.

When UW Medicine’s cardiologists saw the condition of Hayes’ heart, they knew he was unlikely to live long enough to receive a transplant. They gave him a total artificial heart (TAH) to tide him over until a match could be found.

Living with a TAH is not easy, nor is it meant to be a permanent solution. “You’re really limited, because you have your heart on a cart and tubes coming out of your stomach,” says Hayes. Then there was the sound. “Your whole body pulsates,” says Hayes. “It takes a major amount of willpower and mental strength to live that way.”

After 17 months of using the TAH, Hayes was starting to worry — that his job wouldn’t be there for him when he got better, that his insurance would run out, and, most of all, that he’d never find a transplant match. So he called his doctors and asked if anything could be done. Fortunately, it turned out that a brand-new protocol that makes more hearts available for transplant had just been approved.

At its most basic level, this new protocol is a trade: You get a heart. In return, you also get a case of hepatitis C.

Hepatitis C treatments have improved dramatically over the past five years, making organs infected with the disease viable options for transplant. Renuka Bhattacharya, MD, Fel. ’03, a hepatologist and medical director of UW Medicine’s liver transplant program, helped create UW Medicine’s new hepatitis C protocol for hearts and livers — the first of its kind in the Pacific Northwest.

“The risks for this protocol are low, because the treatment for hepatitis C is effective with few side effects,” says Bhattacharya. Thus far, she adds, everyone who has opted to receive a hepatitis C heart or liver, with its corresponding treatment with antivirals, has been cured of the disease.

The benefit of such a protocol is clear: More hearts and livers become available for patients who need them. Since the heart protocol was approved, heart transplants have increased around 10 percent at UW Medical Center.

However, Bhattacharya admits, some people, including some in the medical community, still have some reservations — this is new territory, after all. To help address these concerns, Bhattacharya and her colleagues have worked closely with the hospital education team to make sure that the reading materials and consent forms for patients are appropriate and easy to understand.

Two weeks after opting into this new protocol, Hayes had a match. “My surgeon called and explained the heart’s history to double-check that I still wanted it,” says Hayes. “I remember thinking it would be silly to say ‘no.’”

Silence. That is what Hayes remembers upon waking from his heart transplant surgery. At first, he found it disconcerting to have a heart that worked so well and so quietly.

Then, as expected, Hayes developed hepatitis C. So he began the anti-viral treatment. Eight weeks later, he was cured.

Since his transplant, Hayes hasn’t let much slow him down. He’s back to his job at the oil refinery, riding his Harley and hunting. But he always makes time for his care team when he visits UW Medical Center.

“I pop up to the fifth floor and get a bunch of hugs from everybody,” he says. “I spent a lot of time with them. We became like family. I couldn’t have asked for more.”

Illustration: Simon Shaw