Community Conversation: New Heart and Liver Transplant Program
High-quality care close to home before and after your transplant
Atlantic Health System is now offering patients easier access to life-saving heart and liver transplants through a new partnership with the NYU Langone Transplant Institute. In a Community Conversation on July 22, 2021, Linda Gillam, MD, MPH, FACC, a cardiologist and the Dorothy and Lloyd Huck Chair of Cardiovascular Medicine for Atlantic Health System, and Sharen Anghel, MD, an internal medicine physician and chair of Medicine for Overlook Medical Center, discussed how this program provides New Jersey residents access to world-class transplant care close to home.
What is new about the heart transplant program at Atlantic Health System?
Heart transplant is the definitive treatment for people with advanced heart failure, Dr. Gillam explained. There are 6.2 million people in the United States suffering from heart failure, and a sizeable number of them may be candidates for a heart transplant.
There have been important changes to what determines a heart to be eligible to be transplanted, and that has significantly increased the number of donor hearts available.
Atlantic Health System has always had a comprehensive cardiology program at Gagnon Cardiovascular Institute. Now, services have expanded to include not only pre-transplant evaluation, but post-transplant care in partnership with NYU Langone. The NYU Langone program, one of the largest transplant programs in the Tri-State Area, sees some of the best quality outcomes.
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How has Atlantic Health System expanded its services to include liver transplant?
Dr. Anghel said the liver transplant partnership with NYU Langone provides Atlantic Health System with a transplant hepatologist, a physician with expertise in advanced liver disease, on-site at Overlook Medical Center. The transplant hepatologist is supported by a team of specialists in liver surgery and interventional radiology. The affiliation with NYU Langone will provide patients with a life-saving therapy close to home.
What is the impact of a heart or a liver transplant on the life of a patient?
Dr. Gillam explained that, for patients with advanced heart disease, a transplant is a matter of life or death. And the impact on one’s quality of life is transformative. Despite advances in permanently implantable support devices, or LVADs, patients are still limited in their daily lives. A successful heart transplant returns a patient to a healthy and full life.
A patient in need of a liver transplant does not have the option of a support device. Therefore, Dr. Anghel said: “It is critical for us to have a strong alliance to be able to take care of our patients and their needs, and to identify patients early so that we're able to prep them, pick the appropriate candidates…and hopefully slow down the disease so that some patients may not require (a transplant).”
What is the screening process to determine if a patient is eligible for a transplant?
Patients are extensively screened to identify if they are a candidate for transplant. Factors include blood typing, tissue typing and a psychological as well as a social support system profile. Dr. Gillam said once eligibility is determined, a candidate is listed and assigned a priority score based on a complex set of factors.
How complex is transplant surgery?
A heart transplant operation is not complicated, Dr. Gillam said. “In fact, it's one of the most straightforward operations that we do.”
The complexity comes after the operation during recovery and through the patient’s extended convalescence. Dr. Gillam stated there is a possibility that the transplant might be rejected. Patients who were very sick before the transplant need to return to exercise and build back muscle strength.
The advantage of having a heart transplant at Morristown Medical Center, or a liver transplant at Overlook Medical Center, is that patients can have access to advanced care and expertise close to home.
What are the leading causes of liver disease?
Dr. Anghel said that traditionally, patients with conditions such hepatitis B and hepatitis C were the largest population of those with liver disease. But today, those two viruses can be treated effectively.
Instead, the fastest rising cause of liver disease is a condition known as fatty liver, which is related to medical problems such as diabetes, high blood pressure and other metabolic issues such as weight. Dr. Anghel added that if these factors are caught early, a patient’s health is less likely to deteriorate to the point where they would require a transplant. So, it is important to develop a long-term relationship with a primary care physician.
“Patients who do require a transplant now have a direct line between the two programs so we can help navigate the process before and after transplant,” Dr. Anghel affirmed.
What kind of patients end up needing a heart transplant?
The majority of patients who need heart transplants are those who have pump failure, Dr. Gillam explained.
“The heart is pretty basic in terms of what it has to do. It has to pump, and it has to move blood. And when that pump part of it starts to fail, people get fatigued, they get short of breath.”
Other factors include heart attacks, coronary artery disease, hypertrophic cardiomyopathy and viral infection. She added that it is rare for a person to suddenly need a heart transplant. Rather, heart disease develops over time. She reaffirmed the need to develop a relationship with a doctor who can identify and treat any heart-related conditions early.
Why did Atlantic Health System choose to partner with NYU Langone?
“You could not ask for a better partner. (They have) a superb transplant program,” said Dr. Gillam.
“Their program has grown very quickly. Their outcomes are excellent.” She added that there is a strong connection between their doctors and patients. Dr. Anghel said that NYU Langone is known for their innovation, communication, teamwork, and the relationships they build to foster a strong patient experience.
Does the partnership extend to kidney transplants?
Dr. Gillam said that, for now, the partnership is solely focused on heart and liver transplants. Dr. Anghel said that for patients who may need more than one type of organ transplant, the teams at Atlantic Health System and NYU Langone will coordinate care.
Are there doctors at Atlantic Health System who specialize in post-heart transplant care?
Atlantic Health System has a program called Heart Success that is focused on positive outcomes for patients. The partnership with NYU Langone extends the continuity of care by connecting doctors together in this program.
Is it safe to have a transplant during the COVID-19 pandemic?
Dr. Anghel stressed the importance of vaccination and masking, not only for transplant patients, but for all those who interact with vulnerable populations. “We do everything we can in the hospitals and in our clinics and in our offices to really keep our patients safe no matter what. But, in this heightened era, I think we do that to a significantly larger degree, and that wouldn't change.”
What should I do if I’m worried about my health status?
“My message would be, again, short and simple: if you're worried about something, get it checked out. It may not turn out to be something serious, or it may turn out to be something that's potentially serious that can be cured or absolutely prevented from becoming serious,” said Dr. Gillam. She added that it is important to not ignore symptoms such as shortness of breath.
The physicians of Atlantic Health System have advanced imaging technology and other means of evaluating your heart. Dr. Anghel reiterated the importance of establishing a relationship with a primary care doctor.
“Let us help guide the process because it can be overwhelming.”
When does the partnership with NYU Langone begin?
The relationship between Atlantic Health System and NYU Langone is effective immediately. The office is open and is accepting patients.