Very few people will ever see a human heart.
Fewer still will see the heart they were born with. And then there’s William Roberts, MD. He specializes in cardiac pathology and has studied thousands of hearts during his 50 years in medicine. Since 1993, Dr. Roberts has been at Dallas’ Baylor University Medical Center, which he says performs up to 120 autopsies and about 75 heart transplants each year. Most hospitals properly dispose of surgically removed organs, but Baylor has the space and resources to keep hearts for future study. That allows Dr. Roberts to offer transplant patients the chance of a lifetime: to see and hold their original heart. Since its inception, about 120 people have done just that through the hospital’s Heart-to-Heart program, which Dr. Roberts uses to educate people about heart failure. Texas Medicine asked Dr. Roberts about the program, and how hearts and transplants have changed over the years. Below are his answers.
I grew up in Atlanta, came to [Southern Methodist University] for college, and then returned to Atlanta for Emory Medical School. I interned in Boston, did residency in Baltimore and spent 32 years at [the National Institutes of Health] in Bethesda, Maryland. I came to Baylor University Medical Center in Dallas in 1993 and have been here ever since.
I trained in internal medicine. I trained one year in heart surgery. I trained three years in anatomic pathology. I’m board-eligible in internal medicine, but I never took my boards. I’m also board-eligible in cardiology, but I never took the boards. So you can call me what you wish.
We save all the hearts at Baylor. That’s one of the unique features. We probably have about 10,000 or so. We save the hearts from transplant and autopsy, and we also see everything removed by cardiac surgeons at operation. So we see a lot of valves, tumors, things like that.
The biggest change in cardiac transplant is older people are getting them now.
The biggest change in the heart itself in the last 30 or 40 years is the quantity of adipose tissue, fat, on the heart.
In the early 1980s, when I was in the Washington, D.C., area, at that time only 5 percent of the hearts that I saw floated. Now, at autopsy, it’s over 50 percent. Now, the transplant hearts, about 38 percent of them float in a container of formaldehyde, meaning there’s way too much adipose tissue, fat, there.
The Heart to Heart program, I didn’t start it. I think I’m being given credit for it. But I was walking down the hall at Baylor one day, this was about 10 years ago. Lo and behold, I was walking next to a man, and he said, “Are you Dr. Roberts?” And I said, “Yes, sir.” And he said, “I understand you have my heart.” He said he’d had a heart transplant 10 years earlier and he’d like to see his heart.
That man started telling other people who had had a heart transplant to call up Roberts, and he’ll show you your heart.
We’ve shown about 120 patients who had a heart transplant their hearts. It’s been a very interesting activity.
I try to emphasize to them, you have a major responsibility now to take care of this new heart.
We go over what they eat for breakfast, lunch, and dinner, and between meals or at bedtime, and what are you going to do to change your habits?
We had one young man who was in his early 20s. He had been totally asymptomatic until two months earlier. Lo and behold, he got bad heart failure and he was dying and then had a heart transplant. So he went from total good health to near death in less than two months. He was a bit emotional in seeing his heart.
Often these people bring their spouses, and they often bring their children. I’ve heard from several, “You really affected one of my kids. He’s changed his eating habits a great deal.” That’s quite gratifying.
Tex Med. 2018;114(9):8-9
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