Experiencing increased activity, 2009 saw a record number of patients seen in cardiopulmonary ambulatory care. In 2009 the Clinic celebrated 25 years of heart lung transplantation and was actively involved in two primetime television programs with the Nine Network, ‘The Gift,’ celebrating the gift of organ donation, and ‘Last Chance Surgery.’ As the Clinic moves towards 2010 it prepares for introduction of the total artificial heart program.
Heart and Lung Transplantation The Heart and Lung Transplant Unit provides all thoracic transplant services and mechanical heart assistance for NSW as well as thoracic transplant services for some patients from South Australia and Queensland. Continuing to attract world wide recognition, the Unit’s patient outcomes are significantly superior to international standards. Implementation of a new total artificial heart program will be of added benefit to the Unit and will provide a service to a group of patients who previously would have been unlikely to survive transplantation. St Vincent’s Hospital provides the largest extracorporeal membrane oxygenation (ECMO) program in NSW. In collaboration with Cardiothoracic Surgery and the Intensive Care Unit, the Unit has further developed the indications and utilisation of ECMO for severe respiratory failure refractory to conventional ventilation. To date, this has successfully bridged lung transplantation for four young women with cystic fibrosis. ECMO successfully provided post transplant patients with primary graft dysfunction, all five of whom have fully recovered. In response to NSW Health guidelines, the Unit developed a policy on lung transplantation and donation after cardiac death. Over the past two years introduction of the guidelines has resulted in 20 percent growth in the service delivery of lung transplantation with more than 40 lung transplants per annum.
In 2009 the Unit celebrated 25 years of heart lung transplantation. Joined by NSW Minister for Health, John Della Bosca MLC, and the longest living heart transplant recipient in the Southern Hemisphere, Fiona Coote, the occasion celebrated the success and growth of the Unit’s services. On 23 February 1984, a 39-year-old shearer from Armidale was the first Australian to successfully undergo heart transplantation at St Vincent’s Hospital. Fostering an environment of excellence, the Unit maintains an active research program. An increased ability to provide artificial heart and ECMO support will bring additional activity in 2010 to the Unit and will ensure best possible results.
Pulmonary Hypertension Clinical Trials Since 1999 the Heart Lung Program has engaged in trials to improve clinical outcomes for those with pulmonary arterial hypertension. Under the guidance of Professor Anne Keogh the research group participates in trials with double and triple therapy agents. To date hundreds of patients have benefited from participation in these trials and survival rates have been significantly improved – from 50 percent chance of two year survival to 85 percent. With some of the highest patient participation numbers St Vincent’s Hospital is a world leader in several clinical trials, including a Pfizer examination of sildenafil and a VITAL study of bosentan. Current therapies being trialled include macitentan, treprostinil, riociguat, selixipag and udenafil.
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the Red Cross and a 24 hour telephone counselling and support service is available to transplant recipients from the past 25 years.
Sleep Unit The Unit provides a comprehensive sleep disorders diagnostic and treatment service for a range of respiratory related and non-respiratory sleep disorders including sleep disordered breathing, obstructive sleep apnoea, respiratory failure, narcolepsy, idiopathic hypersomnolence and sleep-wake cycle disorders. Each year the two-bed Unit conducts approximately 390 overnight sleep studies. In addition, portable unattended home diagnostic sleep studies are provided on a limited basis.
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