‘Stanford has saved my life … twice’

Yolanda Ishaq’s “miracle baby” is 25 years old, and Ishaq herself is a grandmother. She continues to thrive after receiving a second heart transplant and a kidney transplant at Stanford Hospital in 2015.

“Stanford has saved my life not once, but twice,” said Ishaq, who lives in Oakland. “They’ve also given my daughter life. It was unheard of to have a baby after a heart transplant.”

Ishaq’s story began about two decades after the late Norman Shumway, MD, PhD, a cardiothoracic surgeon at Stanford, performed the first successful adult human heart transplant in the United States in 1968. In the 50 years since that historic operation, heart transplantation continues to be one of the few treatment options available for end-stage heart disease.

“Heart transplantation opened up a potential life-saving treatment for people who were dying of heart disease,” said Sharon Hunt, MD, PhD, a professor emerita of medicine who was a Stanford medical student when Shumway performed his first transplant. She later became Ishaq’s transplant cardiologist.

Life was ‘literally hell’

For Ishaq, a nagging cold was the first sign that something was wrong. After multiple trips to the doctor, she was diagnosed with an enlarged heart. It could no longer pump blood effectively to her body. She went from working full time and enjoying life to barely being able to walk from one room to another without getting out of breath.

“Life before my first heart transplant was literally hell,” she said. “I couldn’t function as a person on a day-to-day basis with the heart that I had.” When medical therapy failed to improve her condition, Ishaq’s doctor referred her to Stanford. At her first appointment, she knew she was in the right place. 

Her Stanford cardiology team continued to monitor her enlarged heart and placed her on the transplant list when it was clear that the right side had completely failed and the left side was on its way. “I believed they would make me better,” she said. “I love my entire transplant team. Without them, I would not be here.”

She underwent a heart transplant in 1991, and when she became pregnant a year later, she asked Hunt, “Can I keep it?” At the time, the Stanford transplant team discouraged heart recipients from conceiving a child because of the risk of complications to the organ, such as rejection, infection and graft dysfunction, a life-threatening complication that affects the heart’s ability to circulate blood effectively. But Ishaq was willing to do whatever it took to have a baby, and Hunt was ready to help.

“That’s how I had my daughter, Monique,” Ishaq said. “She is the first baby born to a heart transplant recipient at Stanford. The delivery room was packed with 28 people, all of whom wanted to witness the historic birth.”

Ishaq was fine for 24 years with her new heart, and Hunt continued to care for her. But she had a setback in mid-2015 when her heart and kidneys began to fail. Her blood pressure periodically plummeted, causing fainting spells. The first time it occurred was in the middle of the night. Ishaq woke up on the floor, her dog persistently nudging and licking her. His bark alerted her daughter that something was wrong, and Ishaq was rushed to Stanford Hospital. “He is my furry savior,” Ishaq said of her dog.  

Stanford at ‘heart’ of innovation

Ishaq experienced three more of these episodes and three more trips to the hospital. In July of that year, her Stanford cardiologist adjusted her pacemaker to stabilize her condition until a second donor heart became available. 

Ishaq received a second heart transplant on Nov. 9, 2015. Because her body was also showing signs of kidney failure, her Stanford transplant team decided to simultaneously conduct a kidney transplant. 

Today, approximately 50 patients undergo heart transplantation at Stanford each year, and the program has performed more than 1,200 heart transplants over five decades. Stanford remains the oldest continuously operating heart transplant center in the world, and its physicians are responsible for many of the innovations that continue to improve long-term survival. 

Antirejection advances 

Research conducted by Shumway and his team led to the use of the antirejection drug cyclosporine and to an innovative biopsy technique that allows doctors to spot rejection in a transplanted organ earlier, so they can administer antirejection measures to save the heart.

Stanford doctors also performed the first successful simultaneous transplant of the heart and lungs, and the first successful implantation of a left ventricular assist device, which is a mechanical pump that helps weakened hearts circulate blood. Additional Stanford contributions to the field include the creation of the classification system used to determine rejection and the development of a noninvasive way to detect rejection earlier.

“Stanford really is the birthplace of heart transplantation,” said Kiran Khush, MD, associate professor of medicine at the Stanford School of Medicine and a transplant cardiologist who works with physicians, nurses, physical therapists, social workers, dietitians and pharmacists to care for patients before, during and after heart transplantation at Stanford Hospital.

For Ishaq’s daughter, Monique Crawford, Stanford is simply home. “It’s where my son, Jonah, was born. It’s where I was born,” she said. “And it’s where my mom got both of her new lives. Stanford is definitely a special place for us.”