Table Changed: UW Health Cardiologist Receives Rare Transplant | State News

Madison, Wisconsin (AP) — Dr. Matt Wolff has become a heart disease specialist who treats heart disease, but hereditary heart disease can cause people to die suddenly, as his father was 50 years old. I learned that I am suffering from.

After spending years as head of cardiology at UW Health, Wolff underwent a major procedure himself after performing angioplasty to replace the heart valves and remove the occluded arteries. .. It’s a cardiorenal transplant.

Wolff, 60, received the heart and kidneys from the same deceased donor at UW Hospital in October. He was one of five who received a double transplant at the University of Washington last year.

It’s a step he tried to avoid through diet, exercise, medication, implanted devices, and a study of his family history, in the discovery that his great-grandfather died of heart disease in 1900 at the age of 40. I was connected. He died of other relatives, men and women, in their 30s and 40s.

“I worked hard to avoid having to get a transplant, but there is no genetics to escape,” Wolff said.

Due to his heart problems, he stopped performing the procedure in October 2019 and started working half-time looking only at the patients in the clinic. But with his new heart and kidneys, he hikes an ice age trail near his home north of Cross Plains, where he grows organic vegetables. He hopes to get back to work part-time this spring.

“As far as I know, these organs are functioning perfectly,” he said. “I started thinking about everything I was trying to do that was out of the question before.”

When Wolff’s father died of heart failure and arrhythmia in 1978, doctors told his family that the condition was not hereditary. Wolff was 18 years old, a freshman at the College of Wooster south of Cleveland, not far from his hometown of Tiffin, Ohio.

He majored in biology and attended the School of Medicine at Johns Hopkins University in Baltimore.

During his stay at Johns Hopkins, at the age of 27, he decided to specialize in cardiology. He was intrigued by the complex blood flow of the heart and was attracted to procedures that could make people better faster. He was, at least unintentionally, unaffected by his father’s deadly heart condition.

“If it was an effect, it was a subconscious effect,” he said.

Wolf was swimming in the Chesapeake Bay at the age of 29 and felt an irregular, fast heartbeat. He wondered if it was related to his dad’s illness. “It was like a little light bulb in my brain,” he said.

Arrhythmias or atrial fibrillation were common in the early 30s. He read about a family with a genetic form of dilated cardiomyopathy that can be fatal by weakening and expanding the heart muscle, blocking blood flow, and potentially causing irregular heartbeats.

Soon he was convinced that he and his family were in the same condition as he died young or had heart problems. He read the life story of his grandmother. Her father died in 1900 with the old-fashioned term “edema” for swelling due to excess water. The condition known today as edema is often caused by heart disease.

Researchers in Boston tested Wolff’s family and four others to identify a genetic mutation that gives each child of an affected parent a 50% chance of developing dilated cardiomyopathy. This study traces Wolff’s family heritage back to his great-grandfather.

Wolff was listed as a co-author when researchers reported their findings in the New England Journal of Medicine in 1999.

On the family tree paper chart, the squares and circles that symbolize the affected people are shaded, and those without them are blank. Wolff’s Square is half shaded because he wasn’t sure he had all the signs — he said he claimed the disappointment of the lead author.

“It was a great stubbornness on my part,” he said. “I wasn’t ready to admit it at that point. Psychologically, this is a bit of a pain.”

By the time the treatise was published, Wolff had been with UW Health for nearly seven years. He became responsible for cardiology, moved to UnityPoint Health-Meriter for some time, and returned to UW.

Episodes of his arrhythmia were rare but dangerous. “I had to lie down on the floor, put my foot up in a chair, pull down the phone with a cord, call someone and take me,” he said at his office at UW Hospital. I remembered the incident and said. “I was almost dead.”

He received a pacemaker to counter the abnormal heart rhythm. The device has been upgraded to an implantable cardioverter-defibrillator that gives a corrective shock when it senses a life-threatening arrhythmia.

He took many medications for his heart problems, including the ones first tested in mice in his lab. Developed by Array Biopharma, which is currently part of Pfizer, the drug is in Phase 3 clinical trials.

He exercised regularly and was jogging and yoga. He and his wife, Laphage-based Organic Valley marketing executive Kelly, ate a heart-healthy Mediterranean diet, using vegetables grown in their large garden.

But by last summer, Wolff could no longer control the fate of his ancestors. His weakened heart made him unable to garden or practice yoga. “It’s harder to climb the stairs,” he said.

Life-threatening arrhythmias began to occur more often, and the drug was no longer useful. There was also no procedure to burn part of the heart tissue to block the false electrical signal.

After being hospitalized on October 12, Wolff was put on the transplant list. While he was waiting, the doctor inserted a balloon pump into his aorta to help his sick heart keep pumping blood. This is the procedure he took to others.

“I wasn’t sure if he could be transplanted,” said Dr. Jason Smith, a heart transplant surgeon at UW Health. “He got as sick as you could get and was still able to survive.”

Multi-organ transplants are rare but increasing, with 289 cardiorenal transplants nationwide last year, more than double that of five years ago and nearly five times that of 2010.

Other transplant combinations include kidney-liver, kidney-pancreas, and heart-lung. Each is relatively rare compared to a single organ transplant.

According to Smith, it is difficult to access two suitable organs from the same donor. Using organs from separate donors increases the likelihood that the recipient’s immune system will reject them. According to Smith, drugs used after a transplant in one organ can be difficult in the other organ, and patients who need multiple organs tend to get sick, increasing the risk of surgery. There is a possibility.

“It took a long time to figure out who was the right person to get it in this area,” said Dr. Dixon Kaufman, director of the UW Health Transplant Center.

On October 23, the heart and kidneys were made available from the same donor and Wolff matched. Smith and his team had a heart transplant early the next morning, and Kaufman and his team had a kidney. Wolff was fired on Election Day, November 3.

Recovery from the transplant gave him a new perspective.

Previously, he and Kelly thought they needed to shrink because of his poor health and the significant maintenance of their property. Now they are planning to stay for another 5 years.

A family trip with his three daughters, exploring Europe, hiking and rafting in the west, seemed impossible for Wolff to continue. Now he wants to join again when the COVID-19 pandemic is over.

“I had almost stopped planning for the future,” Wolff said. “Now I realized I would be able to do it all.”

His daughter is 26 to 33 years old and lives in Portland, Oregon. They visited for two months after transplantation, following strict coronavirus precautions. He declined to say if any of them had a gene mutation in heart disease.

Wolff adjusted to see only the patients in the clinic and missed the rush treatment of adrenaline, but didn’t call at midnight. His transplants provided more insight into the patient’s experience, from taking difficult combinations of drugs and filling out complex forms to providers who sometimes do not come to appointment on time. Said.

“There are some medical inefficiencies that become apparent when you are on the receiving side,” Wolff said, adding that his treatment was generally superior.

He knows nothing about the organ donor, such as the person’s gender or age. But he understands what happened, as in the case of a deceased donor transplant. In order for him to stay alive, someone had to die, perhaps suddenly and unexpectedly, with a sad family.

In a letter to the donor’s family this month, Wolff expressed grief over their loss and thanks for the gift of his life.

“Your kindness, selflessness, and generosity in the settings I imagine are terrible, and unexpected sorrows are inspiring,” he writes.

His transplant was a gift, “I continue to be grateful every day, do my best to deserve it, and try to give back.”