Cheney transplant reopens age debate

CHICAGO - Doctors say it is unlikely that former Vice President Dick Cheney got special treatment when he was given a new heart at age 71.

Still, his case reopens debate about whether rules should be changed to favor youth over age in giving out scarce organs. As it stands, time on the waiting list, medical need, and where you live determine the odds of receiving a new heart - not how many years you'll live to make use of it.

Cheney had the transplant Saturday at Inova Fairfax Hospital in Falls Church, Va., where he also received an implanted heart pump that has kept him alive since July 2010. It appears he went on the transplant wait list about then, 20 months ago.

He had severe congestive heart failure and had suffered five heart attacks in 25 years. Yet he must have had a healthy liver and kidneys to qualify for a new heart, doctors said.

"We have done several patients hovering around age 70," although that is about "the upper limit" for a transplant, said Mariell Jessup, a University of Pennsylvania heart-failure specialist and American Heart Association spokeswoman. "The fact he waited such a long time shows he didn't get any favors."

More than 3,100 Americans are waiting for a new heart, and about 330 die each year before one becomes available. When one does, doctors check to see who is a good match and in highest need. The heart is offered locally, then regionally, and finally nationally.

"You can't leapfrog the system," said Allen Taylor, cardiology chief at MedStar Georgetown University Hospital.

Jessup and Taylor spoke Sunday from the American College of Cardiology's annual conference in Chicago.

Patients can get on more than one transplant list if they can afford the medical tests that each center requires to ensure eligibility and can afford to fly there on short notice if an organ becomes available.

"Most centers wouldn't put somebody on" at Cheney's age, said Penn bioethicist Art Caplan, who has testified before many panels on organ-sharing issues.

"I've been arguing for a long time that the system should pay more attention to age because you'll get a better return on the gift" because younger people are more likely to live longer with a donor organ, Caplan said.