godfather of surgery

Chapter 1200 Artificial Heart
They came here because of its reputation, so why would they disagree? The couple felt guilty after finding their child, because if they hadn't lost their child, the child might not be in this situation now.

So now, as long as there is a glimmer of hope, they are willing to pay any price.

In fact, they don't have many other options. Under the current objective conditions, patients who want to have a heart and lung transplant have to wait for a suitable donor, and it's unknown when that will be. However, if they want a piggyback heart transplant, there are suitable donors available now, and the surgery can be performed at any time.

Given the patient's current condition, with both severe heart failure and pulmonary hypertension, he might die from heart failure the next day. Solving the problem as soon as possible is the only strategy.

"Is there anything else you don't understand?"

Yang Ping tries his best to make sure that patients and their families understand everything clearly, rather than leaving them confused.

The patient's father looked at the heart model and asked, "Professor Yang, you said that after the surgery, he would have two hearts in his body."

"That's right. After the surgery, he will have two hearts: his own current heart and the new heart that has been transplanted. It's like he has two engines. Although his own engine is no longer very powerful, it can still provide some power to share the workload with the new heart. This way, the transplanted heart won't have to bear so much pressure, which ensures the highest success rate of the surgery and guarantees that the transplanted heart can work healthily for a long time after the surgery, instead of failing due to high workload." Yang Ping repeated, knowing that the patient's family members were not experts and would need some time to understand.

"As long as it can save a life, do it!" the patient's mother said immediately, fearing that the doctor would change his mind and say that the surgery was not possible.

"When will the surgery be performed?" the patient's father asked.

Yang Ping looked at Director Tian and asked when the surgery would be scheduled. The most crucial factor was when a donor would be available. Once a donor was found, the surgery could be performed immediately.

Director Tian said, "Actually, the preoperative preparations have been completed. We will supplement any items that need to be re-examined, and we can arrange the surgery at any time. We will coordinate with the donor."

The vast majority of organ transplant surgeries are emergency surgeries, often performed in the middle of the night, because the availability of donors is uncertain. Brain-dead patients are a minority of donors. In cases of brain-dead donors, organs must be harvested immediately upon death, and surgery must be performed at the same time. Brain-dead patients are temporarily kept alive by machines. Although the brain tissue has died, the body is not actually dead under the maintenance of the machines. Therefore, in such cases, there is a possibility of elective organ harvesting.

"Professor Yang, please have a seat. I'll be right back in a few minutes."

Tian Yuan left for a while to make a phone call to coordinate with the donor. Organ transplant recipients and donors are both kept in the dark; the recipient doesn't know who provided the organ, and the donor's family doesn't know who the organ was given to either. Therefore, Tian Yuan was contacting the First Affiliated Hospital of Nanjing Medical University about organ provision in a way that avoided the family.

Yang Ping understood what he meant and nodded. The specific surgery time could only be determined after Tian Yuan confirmed when the donor organ could be provided.

"Professor Yang, please help me. My child has had a hard life, you must help him." The patient's mother's eyes were red.

Yang Ping nodded slightly: "Please rest assured, we will do our best."

"How long can a transplanted heart typically last?" The patient's father asked again during this brief pause. He had been so anxious that he hadn't thought of many things earlier, but now some questions came to mind.

Yang Ping replied, "It's hard to say. Postoperative life expectancy depends on many factors, not just the heart. The longest-lived heart transplant recipient in the world has lived for 40 years. That is, after a heart transplant, he extended his life by 40 years thanks to the new heart. We also have a record of about 30 years of survival after the procedure in China."

Forty years! Although this is the longest record in the world, it has given the patient's parents great confidence that the condition can be extended for so long. With the development of medicine, there may be better methods in the future.

"He also has pulmonary hypertension. If the pulmonary hypertension continues to develop, a lung transplant can be performed at the appropriate time, so that the pulmonary hypertension can also be treated." Yang Ping also told them about the possible future options.

In fact, heart-lung transplantation is possible now, and technically it's not a problem at all. However, there are currently no qualified donors for heart-lung transplantation, so the surgery must be performed based on objective conditions.

About ten minutes had passed, and Director Tian still hadn't returned. The patient's parents looked anxious, glancing at the door of the meeting room every now and then, worried that something might have gone wrong with the donor organ.

More than ten minutes later, Tian Yuan returned. The patient's parents' worries were not unfounded. He brought bad news: the heart had already been donated to someone else, and the surgery had just been completed.

Upon hearing this news, the patient's parents suddenly froze, their faces turning pale.

I was just feeling happy, but now my mood has plummeted to rock bottom. Finding an organ transplant donor is the hardest thing to do; sometimes you have to wait a long time and there's no guarantee that a suitable donor will be available.

"There's nothing we can do but continue waiting for a donor." Director Tian had no choice but to respect the objective facts.

Donors' organs are not assigned to a specific person. They are given to whoever needs them and is a match. It's impossible for a donor organ to be waiting for a patient.

"Then...then...can the child hold on until a donor is found?" The patient's mother visibly shed tears. Some things are just like that, changing in an instant.

Yang Ping said, "It's hard to say. The waiting time is uncertain. The patient currently has severe heart failure and is in danger of dying at any time. Even if we use an artificial heart-lung machine, it will only be an aid and cannot be relied on to sustain life for a long time." The patient's father's lips trembled. He wanted to say something, but he trembled for a long time and said nothing. The patient's mother took out a tissue to wipe her tears. If it weren't in front of the doctor, she would definitely have burst into tears.

“However, there is another way we can use,” Yang Ping said, his tone shifting.

As patients or their families, when they are in despair, what they most want to hear from doctors is a change of tone, and this "but" immediately rekindles their hope.

"What other options are there? Professor Yang, we're willing to try anything, as long as it can save our child's life, even if it's just to buy him a little time to wait for a donor heart," the patient's father said impatiently.

Yang Ping said slowly, "We can implant an artificial heart first, so that the artificial heart can buy some time. And before the advent of allogeneic hearts, we can continue to maintain life with an artificial heart."

"An artificial heart?" the patient's father exclaimed in surprise.

In fact, this was just Yang Ping's alternative plan. After all, allogeneic hearts are much better in terms of function than artificial hearts. However, the objective conditions have changed, so the plan naturally has to change as well. Since there are no heart donors available, they can only settle for second best and use artificial heart transplantation surgery.

"That's right. An artificial heart is a small machine that can simulate heart function. It can be implanted in the body to replace the heart. We can implant an artificial heart in him, and while waiting for a donor, the artificial heart can act as a substitute for the heart. However, it is very expensive."

“That’s not a problem, we’ll do whatever you say, Professor Yang.” The patient’s father immediately perked up, and his mother stopped crying and leaned closer, hoping to hear him more clearly.

"Can he hold on until he has a heart condition?" The patient's mother was very worried. She had been suffering from depression for more than 20 years because of the loss of her child, so she was always sensitive and anxious.

“Yes! At worst, the artificial heart can be replaced multiple times along the way. Generally speaking, with the latest fully magnetically levitated artificial heart, there are cases in my country where patients have survived for 15 years after surgery. So you don’t need to worry about its lifespan at all. It’s enough to support him until a heart donor becomes available. Even if there is no heart donor, he can rely on the artificial heart to maintain his life first. When a better artificial heart is available in the future, he can be replaced with a better one.” Yang Ping spoke with confidence and clarity, which gave the patient’s parents great confidence.

This is a good idea, but according to Professor Yang, an artificial heart is definitely not as good as a human heart. The longest recorded lifespan of the artificial heart is 40 years, while the artificial heart has only lasted for more than ten years. The patient's father thought about it, and an extremely bold idea popped into his mind. For his son, he was willing to risk everything.

“Professor Yang, I have an idea, but I don’t know if it will work. You see, I am his biological father, we are related by blood, and the matching should be no problem. Could you donate my heart to him and then put an artificial heart in me? Anyway, I’ve lived for over fifty years, and I don’t care how much longer I can live, as long as he is well. What do you think of this plan?” the patient’s father proposed.

A father's love is as strong as a mountain, and this father's love was fully demonstrated at this moment. When he put forward this plan, he did not hesitate at all, and he looked very happy, as if he had found the best solution for his son.

“Old An!” The patient’s mother tugged at her husband. “Professor Yang, he is the pillar of our family. I am the patient’s mother. My heart should be the most suitable. He is my child, whom I carried for ten months. He is definitely the best match.”

The mother couldn't bear to let her husband do this, so she was willing to take his place. She wondered why she hadn't thought of this before. Suddenly, she realized it was a very good solution.

After Yang Ping and the others finished speaking, they said, "No, a heart transplant donor cannot come from a living person."

“But a friend of mine had a kidney transplant, and he donated his own kidney.” The patient’s father insisted, “Why can others do it, but he can’t?”

Yang Ping immediately asked Director Tian to bring over a model of the abdominal organs. He liked to explain things to patients and their families using the model, as it was very intuitive.

A quick-witted PhD student nearby immediately brought out a model of the abdominal organs. Yang Ping pointed to the model and said, “Whether it’s a kidney transplant or a liver transplant, both can be done with living donors. You see, a person has two kidneys, but a person only needs one healthy kidney to survive. Even if they donate one kidney, it doesn’t affect their survival. So if a person has two healthy kidneys, they can donate one. If they only have one healthy kidney, they can’t donate it; they wouldn’t be able to survive afterward. The liver is similar. Although a person only has one liver, it has a significant characteristic—a strong regenerative capacity. Utilizing this characteristic, a liver transplant involves transplanting a portion of the liver, not the entire liver. After the donor loses that portion, it will regenerate over time, and the recipient’s portion will also gradually grow larger and function as a full liver. The heart is completely different. Each person only has one heart, and the heart has no regenerative capacity and cannot be partially transplanted. Therefore, a heart donor cannot survive without their heart. From a medical ethics perspective, it is absolutely unacceptable to use one person’s life to save another.”

"Can't I even volunteer? I'm willing to bear all the consequences," the patient said excitedly. It seemed that his desire was very strong, and it became even stronger after he learned that the plan was technically feasible.

“No! It’s absolutely forbidden ethically, it’s impossible, you don’t need to think about this plan anymore,” Yang Ping told him firmly and clearly.

The patient's father was still unwilling to give up: "Anyway, I can survive temporarily with an artificial heart, for as many days as I can. I'm an old man and will leave sooner or later, but he's a young man and has a long life ahead of him."

"Let's not bring this up again. I'm telling you again, this is absolutely impossible. Let's discuss a solution that aligns with objective facts. Any solution must be based on objective facts. Currently, the only solution that aligns with objective facts is to use an artificial heart to buy time. We can perform an allogeneic heart transplant later when conditions permit. Discussing unrealistic solutions is a waste of time." Yang Ping got straight to the point, without any ambiguity, directly extinguishing the patient's family's unrealistic ideas. He didn't waste time arguing with them, making them completely abandon their unrealistic thoughts.

"How long can the artificial heart last?" The patient's father was still worried.

Yang Ping said, "As I just mentioned, the fully magnetically levitated artificial heart is the third generation of artificial heart technology. Nearly 90% of patients can survive for more than three years, and the longest in China has reached 15 years."

After three years, there is a high probability that a heart donor has been found. The patient's parents breathed a sigh of relief. If they can hold on for three years, the hope is still very high, at least they have gained enough buffer time.

“We must be realistic and not have any ideas that are out of touch with reality. Based on his actual situation, the only solution is to perform an artificial heart transplant—preserve his original heart and connect an artificial heart in parallel, using the artificial heart’s ‘mechanical pump’ to assist in pumping blood. There is no need to wait for a donor, and his life can be saved quickly.”