The Challenge: Transposition of the Great Arteries
Michelle Hagerty has had a lifetime of heart issues. Born with transposition of the great arteries, Michelle had her first open heart surgery shortly before her third birthday.
Transposition of the great arteries occurs when the aorta and pulmonary arteries switch places.
The 42-year-old Erie, Pa., native went on to experience the trials of her diseased heart for most of her life.
“I’ve had countless procedures, tests, pacer/ICDs, and medications my whole life,” she said.
Unfortunately, a lifetime with a heart defect eventually caught up with her. In 2009, doctors diagnosed Michelle with heart failure.
“Things really went south. I was getting weaker. I was getting sicker.”
Adding complexity to the case, Michelle’s many surgeries and blood transfusions had sensitized her immune system.
When doctors approved Michelle for a heart transplant in 2016, they recognized the tough task ahead of them. They had to find a viable heart that Michelle’s body would tolerate with minimal rejection.
“Michelle was a challenging transplant,” says Christopher Sciortino, MD, Michelle’s heart transplant surgeon.
But, Dr. Sciortino presented Michelle with a unique option to help find a heart for her. He suggested a donor heart positive for hepatitis C anti-bodies, although not the disease itself.
The Solution: A New Heart
“It’s a case of balancing risks,” Dr. Sciortino says. “With the new drugs, the risk of dying from hepatitis C is very small. And you balance that against Michelle’s risk of dying from congenital heart disease, which was much, much higher.”
A new generation of antiviral drugs has raised the cure rate of hep C to 95%. Some hospitals — including UPMC — are using this progress to access a larger donor pool, including hearts with hep C antibodies.
This effort shrinks the gap that exists between donor organs needed and organs available.
While discussing her placement on the heart transplant waiting list, Dr. Sciortino mentioned entering the pool of Hepatitis C antibody donors.
Michelle discussed the risks and benefits with her husband and the care team, then agreed to enter that pool as well.
“UPMC has established a conservative research protocol that helps us [utilize these donor hearts] in the safest way possible. I want to provide my patients with whatever advantage they can get as long as it is safe,” Dr. Sciortino explains.
Michelle’s husband, Bill, echoes Dr. Sciortino’s sentiments. “Once they explained the program to us, it was a slam dunk. We both looked at each other and said, ‘let’s do it.’"
After waiting 10 months at home with no offers, doctors admitted Michelle to the hospital. They placed her at the top of the waiting list due to the seriousness of her illness and frailty of her heart.
But, even her high placement on the list didn't guarantee a heart would be available right away. Michelle ended up waiting a little over four months more in the hospital.
“After 129 days in the hospital, I finally got my call. My coordinator came on the line and said, ‘we found you a match,’" Michelle explains.
The heart available for Michelle tested positive for hepatitis C antibodies, but not for the disease itself. This meant it was less likely to put Michelle at risk for infection.
The Result: A New Life
“I knew immediately there was a huge, huge, difference,” Michelle exclaims. “It worked. I have a new heart.”
Dr. Sciortino recognizes Michelle’s willingness to trust her heart transplant care team’s guidance and opinions when deciding her course of treatment.
“Honestly, if not for the hep C, this heart probably would have gone to somebody else. And Michelle would have had to keep on waiting,” Dr. Sciortino explains.
“Michelle is a shining example of how well somebody can do when they take ownership of their health care. She knew her labs, knew her charts, and took charge of her health.”
“I can do pretty much anything I want to do, and I can keep up with my husband,” Michelle exclaims.
Life after transplant has been good to Michelle.
It's given both her and her husband the chance to continue living the life they love together, whether they're:
- Go to baseball games
- Or just enjoying a quiet night at home with their dog
Michelle and Bill are grateful for their time together, Michelle’s care at UPMC, and the trust they placed in her donated heart.
Michelle’s treatment and results may not be representative of all similar cases.