AHFTC History

The Stanford heart transplant fellowship, established by Dr. Sharon Hunt in 1989, was the first program of its kind in the world to offer advanced training in the care of heart transplant recipients. The launch of the fellowship program was one of a series of ground-breaking innovations in the fields of advanced heart failure, heart transplantation, and mechanical circulatory support (MCS) at Stanford.

Stanford heart transplant/MCS milestones

1960: First description of the surgical technique for orthotopic heart transplantation by Drs. Norman Shumway and Richard Lower¹

1968: First heart transplant in the United States performed by Dr. Norman Shumway

1975: Development of the endomyocardial biopsy technique for diagnosis of heart transplant rejection by Dr. Philip Caves, a surgical fellow at Stanford²

1977: Documentation of donor heart function after cold preservation, leading to use of distant heart procurement

1981: First combined heart-lung transplant performed by Drs. Norman Shumway and Bruce Reitz

1984: First use of left ventricular assist device (Novacor) as a bridge to heart transplantation by Dr. Philip Oyer

1985: First classification scheme for biopsy grading of acute cellular rejection proposed by Dr. Margaret Billingham, cardiac pathologist at Stanford³

1989: Stanford heart transplant fellowship program established

1992:Development of intravascular ultrasound (IVUS) to detect early development of cardiac allograft vasculopathy⁴

1999: 1,000th heart transplant performed at Stanford Hospital

2010: Publication of landmark trial on gene expression profiling for non-invasive rejection surveillance after heart transplantation, led by Stanford investigators⁵

2012: Fellowship program expanded to include training in MCS

2013: AHFTC Fellowship program becomes ACGME certified and expands to 3 fellows per year

2013: First catheter based deactivation of a left ventricular assist device after myocardial recovery⁶

2014: Donor-derived cell-free DNA developed as a novel non-invasive tool for rejection monitoring after heart transplantation^{7, 8}

References

Lower, R. R. & Shumway, N. E. Studies on orthotopic homotransplantation of the canine heart. Surgical forum 11, 18-19 (1960).
Caves, P., Coltart, J., Billingham, M., Rider, A. & Stinson, E. Transvenous endomyocardial biopsy--application of a method for diagnosing heart disease. Postgraduate medical journal 51, 286-290 (1975).
Billingham, M. E. Endomyocardial biopsy detection of acute rejection in cardiac allograft recipients. Heart and vessels. Supplement 1, 86-90 (1985).
St Goar, F. G. et al. Intracoronary ultrasound in cardiac transplant recipients. In vivo evidence of "angiographically silent" intimal thickening. Circulation 85, 979-987 (1992).
Pham, M. X. et al. Gene-expression profiling for rejection surveillance after cardiac transplantation. The New England journal of medicine 362, 1890-1900, doi:10.1056/NEJMoa0912965 (2010).
Zeigler, S. M. et al. A novel, catheter-based approach to left ventricular assist device deactivation after myocardial recovery. The Annals of thoracic surgery 98, 710-713, doi:10.1016/j.athoracsur.2013.09.073 (2014).
Snyder, T. M., Khush, K. K., Valantine, H. A. & Quake, S. R. Universal noninvasive detection of solid organ transplant rejection. Proceedings of the National Academy of Sciences of the United States of America 108, 6229-6234, doi:10.1073/pnas.1013924108 (2011).
De Vlaminck, I. et al. Circulating cell-free DNA enables noninvasive diagnosis of heart transplant rejection. Science translational medicine 6, 241ra277, doi:10.1126/scitranslmed.3007803 (2014).