Dr. Shih-Ying Sung, Cardiovascular Surgery Division

All of a sudden, health can change dramatically

The outgoing and extroverted 58-year-old Mr. Cheng impressed us at first sight. He concluded his medical history with "I’m quite healthy in general and have no major health issues!" However, Mr. Cheng started experiencing symptoms such as chest tightness and cold sweats at the beginning of the year so he visited our Cardiology OPD. After being checked using ultrasound, he was found to have only 15% cardiac systolic function. He was admitted for a series of examinations and dilated cardiomyopathy was ruled out. It is not easy to find an organ for patients with end-stage heart failure. However, thanks to technology, Mr. Cheng underwent HeartMate III ventricular assist device surgery in March 2023 and was discharged mid-April with follow-up treatment in the OPD while he waited for a transplant.

On November 2^nd, 2023, Mr. Cheng fainted when something upset him at home and he was sent to the ER. His EKG showed ventricular fibrillation and his heartbeat returned after three defibrillations. Mr. Cheng was admitted for treatment while awaiting an update from the Taiwan Organ Registry and Sharing Center (TORSC). After more than eight months of waiting, the precious heart graft was available on November 30^th. On December 1^st, the team split into two groups; the "heart harvesting group" went to Linko CGMH, and the "recipient group" stayed at the hospital. The harvesting group sent an image of the beating heart at 9:30. Director Chien-Sung Tsai performed the surgery to remove the HeartMate III ventricular assist device, which added a layer of complexity to the transplant surgery. The surgery was completed at 17:57 and the patient was transferred back to the ICU, marking the 250^th heart transplant surgery case completed by Cardiovascular Surgery Division team.

Learning from the past and marching forward to the future

TSGH has dedicated 35 years of effort. With the approval of the DOH in 1988, Professor Jeng Wei started human heart transplants and completed the first successful human heart transplant in Asia, which was not only an honor for TSGH, but for Taiwan. Professor Chien-Sung Tsai inherited the foundation set by his teacher in 1999 to take the Cardiovascular Surgery Division forward. By 2004, the only DOH-approved artificial ventricular assist device – the Thoratec Ventricular Assist Device (VAD) system – was placed in a patient. In 2018, Dutch expert Professor Dr. Lahpor was invited to complete the first Heart Mate III ventricular assist device (VAD). VADs play an important role as bridging therapy for heart transplant patients. Due to the challenges of matching hearts with patients with end-stage heart failure, VADs can significantly extend the waiting period for patients and increase their chances of getting a heart.

Team collaboration

The number of visiting doctors has amounted to 10 physicians to date, and every one of them is aggressively involved in the heart transplant program, playing their own important roles. Professor Chien-Sung Tsai is the team leader and leads the team in the march forward. Professor Yi-Ting Tsai is an expert specializing in heart transplant surgery and HeartMate III ventricular assist devices. Professor Chih-Yuan Lin and Chief Hung-Yen Ke are responsible for planning and consolidating all transplant surgery related tasks. Dr. Po-Shun Hsu and Dr. Hsiang-Yu Yang are focusing on short-acting ventricular assist devices, Dr. Yi-Chang Lin and Dr. Shih-Ying Sung are in charge of the important stage of harvesting hearts, Dr. Chien-Ting Liu and Dr. Jui-Tsing Chang are responsible for patients' post-transplant critical care, and two Registered Nurses, Chun-Wen Hsu and Jin-Ting Chiang, care for patients under the case management system. All the team demonstrate great teamwork.

Taking from society, and appreciating and giving back

The selfless love from the local community allows our team to reach new milestones. With contributions from donors and their families, grief turns into love and power. TORSC and the organ donation coordinator make great effort to ensure loved ones' wishes are fulfilled. The team of the Taiwan High Speed Rail and police officers help to transport organs to ensure patients receive their donors' organs; all of which are a driving force keeping us moving forward. From the very first surgery to the 250^th, we have never spared any effort and will continue to do so.