The heart of the matter

Woman out of options when she received transplant on short notice

By Herb Frazier

The Post and Courier

January 23, 2006

As Barbara Gathers' heart continued to weaken a year ago, a not-so-subtle alarm warned that the cardiac therapies her doctors chose for her were not working.

She could not climb the 15 steps to the loft at her home in Charleston. She paused on the short walk from her car to her office at the Army Corps of Engineers.

Then in April, she took medical leave. Gathers had about six months to live.

It was decided she needed a healthier heart.

Her name was placed on the heart transplant list at the Medical University of South Carolina. Two weeks later, Gathers was admitted to the hospital Aug. 21, after her condition declined further.

The day after she was admitted, the heart from a 20-year-old male that matched Gathers' medical profile unexpectedly became available to her.

A seven-hour transplant operation was performed much sooner than anyone had expected.

Gathers was on the heart transplant list for just two weeks, one of the shortest waits for a heart among transplant patients at MUSC.

Earlier this month, Gathers returned to work at the Army Corps of Engineers, where she is the equal employment opportunity officer. She plans to work half-days then return to a full-time schedule in March.

"I feel blessed. My belief in God made me realize he was going to bring me through," she said recently at her Wagener Terrace home.

"In less than two weeks, they found a match. I didn't go in that particular night for the transplant. I went in because I was feeling badly and felt that I needed emergency care."

Gathers had cardiomyopathy, a condition that enlarged her heart muscles.

MUSC cardiologist Adrian Van Bakel said in the six to eight months before the operation, Gathers' condition "had dramatically deteriorated. I would have given her six months to live."

Gathers' short wait time for a heart "is pretty rare, but it does happen," Van Bakel said. "It happens about 5 percent of the time."

Last year, Gathers was one of 20 people who received a heart transplant at MUSC, the state's organ transplant center.

At MUSC, heart transplant patients on average wait about 2 1/2 months for a heart, Van Bakel said. Nationally, he said, the average wait time is about eight months.

Heart transplant patients in South Carolina have a shorter wait, he said, because the state has more heart donors than people who need them. MUSC has no competition for hearts, increasing the chance that hearts are available sooner, he said.

In South Carolina, LifePoint, based in Charleston, is the nonprofit organization that is licensed to procure hearts and other organs and human tissue for transplantation.

Sue Poveromo, communications editor for LifePoint, said, "We are fortunate to obtain so many organs that are in good condition for transplant. In South Carolina, the number of heart donors far exceeds the number of those waiting for a heart. Overall, the amount of organ donors in South Carolina has steadily increased. Last year was a record number for us."

Last year, LifePoint procured 548 organs, including 47 hearts.

Mike Waslaske, LifePoint's manager of organ recovery, said, "Even though we had a record year for organ donors, we still never have enough donors to completely meet the need of those waiting for kidneys in South Carolina."

Until August, Gathers will remain at a relatively high risk of her body rejecting her new heart, Van Bakel said. "This risk diminishes with time in most people such that the risk is low," he said.

The transplant wasn't the first option for Gathers. In October 2004, Gathers received a defibrillator, a device that produces an electrical shock to the heart when it detects a disturbance. Then in May 2005, she got a biventricular pacemaker combined with a defibrillator to synchronize her heart beat.

Van Bakel said Gathers is not unusual to have received the two devices. She is unusual in that they did not work. "If a patient responds, it can improve heart function, but she did not respond well," he said.

Five years ago, clinical trials concluded that a defibrillator or biventricular pacemaker are effective in prolonging life and improving symptoms in patients with severe heart failure before a transplant is considered, he said. "This means that more people will not require transplantation, and it means people who are disqualified because of age or other medical problems from getting a transplant can also have a better quality of life."

Regardless of the cost, Van Bakel said he would prefer to exhaust every possible remedy to prevent a patient from having a transplant. "Although a transplant is great for people who need it, it is not a ticket to a normal life span. If a patient needs a transplant and medically qualifies for one, the use of biventricular pacemakers and defibrillators is necessary to keep them alive until a heart is available. We can't withhold a life-saving therapy," he said.

Seven years before the transplant, Gathers learned that she had a bad heart. She had a mixed reaction to the news.

First she was surprised, considering her lifestyle. She ate properly and exercised. She chose a vegetarian diet that included fish and poultry. She bought exercise equipment for her home. She had smoked for about eight years, but she quit in 1978.

Gathers said she was health conscious because of her family's medical history. Her mother, Mildred Washington, and Gathers' maternal grandparents, Corrine and Abednego Gathers, were the victims of heart disease, and other relatives have heart problems. "By eating right and doing the right thing, I thought that I could ward it off," she said.

Gathers said she only told one relative that doctors had given her a short time to live.

"I didn't want folks feeling sorry for me and looking at me differently, so I kept that to myself."

When she was told that her life was ending, Gathers said, "I didn't say, 'Oh, gosh, I might be dead in a year. Oh, poor me.' Because of my faith, I knew something would happen for the best. And it did."

She also feels blessed to have received more than the heart. She was donated sick leave from friends, relatives and people she does not know who work for federal agencies. It has allowed her to be on leave since September. She also received help from relatives and friends who came to her home to cook for her.

With the heart of a 20-year-old, Gathers said she is beginning to feel "almost back to myself."

Although the donor is anonymous, Gathers has written to his family through LifePoint. "I would like to know who he was. I am just curious. I am just so thankful for the heart," she said.

She also expressed sympathy to the donor's family. That letter was mailed three months ago. So far, she has not received a reply.

Copyright © 2006 The Post and Courier, Charleston.net.

This article posted February 18, 2006.