MCG's 1st heart transplant comes in time to save man

Freddie McCullum and his wife, Shirley, got to celebrate their second anniversary Tuesday, and now he can look forward to his 42nd birthday Friday, thanks to the heart of a stranger.

 

Mr. McCullum was days away from death last week when he became the first heart transplant patient in the history of Medical College of Georgia Hospital and Clinics.

"We've got anniversary and birthday all rolled up into one," Mrs. McCullum said. "April will be our blessed month."

The transplant culminated a five-year effort by the health system and transplant surgeon Kevin Landolfo to bring the service to Augusta, which would make it the only program in the area outside of Atlanta or Charleston, S.C. There are 76 patients waiting for a heart transplant in Georgia and 11 waiting in South Carolina, with most waiting more than a year, according to the United Network for Organ Sharing. Nationally, there were 2,210 heart transplants performed last year, but 317 patients died awaiting a new heart.

University Hospital did three heart transplants in the late 1980s but found that so few cases couldn't justify the expense when patients were more likely to have better outcomes at busier centers, said Marilyn Bowcutt, the vice president for patient care services.

In MCG's case, it has been a matter of assembling all the people and pieces it needed, said Dr. Landolfo, the director of the heart transplant program and chairman of cardiothoracic and vascular surgery.

"It's not really one surgeon or one physician. It requires a lot of specialized personnel," he said. "These people require very intensive social and follow-up care for almost every facet of their lives."

Because of the high costs of the medications transplant patients must take for the rest of their lives, the McCullums, of Stone Mountain, had been turned down by an Atlanta transplant program after Freddie lost his insurance and they couldn't raise the necessary financial commitment, Mrs. McCullum said. But they were able to work out it out with MCG, she said.

"God made a way for us to come here," Mrs. McCullum said. "He made a way for him to get the surgery. I call it a miracle."

Dr. Landolfo calls it a commitment from the institution to make the transplant program happen.

"We're in a fortunate position as we're trying to develop and grow this that the institution is making more resources available," he said.

And it could not have come a moment too soon. Mr. McCullum was in intensive care in severe congestive heart failure, being kept alive by intravenous medication, when the donor heart became available.

"He was day to day, critically ill," said Chandra Kunavarapu, the congestive heart failure transplant cardiologist.

"Definitely less than a week," said transplant surgeon Vijay S. Patel. "I think he almost died."

Because the donor heart was in Atlanta, and the heart can only survive four hours outside the body, the teams involved had to be coordinated and timed perfectly, Dr. Landolfo said. Then came the dramatic moment, after the ailing heart has been taken out and the new one sutured into place.

"And it's very quiet, because the heart is still. And usually the room is very quiet," Dr. Landolfo said. "And initially the heart doesn't do anything. And slowly the heart really comes alive, it starts to beat, and it starts to beat with more force. It's a very remarkable and magic event."

The change is evident a week later in Mr. McCullum.

"My whole body feels stronger. I've got the appetite I used to have when I first got sick," said Mr. McCullum, who lost 50 pounds.

He said there is no doubt in his mind what he will do next.

"Do the work that the Lord wants me to do," he said. "That's the reason why I'm here, to do his work."

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.

ANATOMY OF A TRANSPLANT

It took an "orchestra" of skilled personnel to get a donated heart from a hospital in Atlanta into Freddie McCullum at Medical College of Georgia Hospital, said transplant surgeon Kevin Landolfo.

- Once the family gives consent, the donor's information goes to a national clearinghouse, which turns to the waiting list of those who need a heart. Patients are matched by blood group and size with the donor, and location, and also ranked by the severity of illness. Mr. McCullum was so sick he went to the top of the list.

- The clearinghouse contacts MCG Hospital, and the surgeon has to accept the organ.

- The team has to coordinate with others who are receiving organs from the donor to set up a time for the operation.

- A plane is called, and Dr. Vijay Patel heads to Atlanta to remove the heart. Timing is critical, because the heart remains viable only for four hours outside the body.

- While Dr. Chandra Kunavarapu gets Mr. McCullum ready for surgery, Dr. Landolfo preps the operating room. By the time Dr. Patel starts to remove the heart, Dr. Landolfo has Mr. McCullum in surgery.

- As Dr. Patel is en route, Mr. McCullum is on heart-lung bypass and prepped up to the point of removing his heart.

- The moment Dr. Patel enters the hospital, Dr. Landolfo starts to remove the ailing heart. Dr. Patel and Dr. Landolfo then take the new heart, sew it into place and take off the clamp that allows blood to flow into it.

- After a slight hesitation, the heart begins beating. About three hours have elapsed since it was removed from the donor.