As the weeks passed this spring, Anna Linck's heart condition grew progressively worse, and death closed in.
The 24-year-old Long Lake woman needed a new heart -- and fast. But finding the perfect heart for transplant from the perfect donor had proven elusive.
Just down the hall at Abbott Northwestern Hospital, 30-year-old Keilee-Rae Miller, a Richfield resident, was on the list for a new heart, too.
They bonded while waiting almost three months in the Minneapolis hospital for the phone calls that would change their lives. They baked scones. They wrote in a diary. They said goodnight to each other every night at 9.
The call bearing news of a donor heart came first for Miller. "It was the hardest thing I'd ever done, telling Anna I was going first," she said. "I wanted it to be her."
But Linck was rooting for her new heart sister. "I was happy when Keilee got her heart first," she said. "We pulled each other through."
The two women helped usher in a new era of heart transplant surgery at Abbott, whose transplant numbers historically have lagged behind the University of Minnesota and the Mayo Clinic.
Transplants were infrequent enough that the program found itself in danger of extermination in 2007, when the federal government warned Abbott that it might not qualify for Medicare funding because of the low transplant volumes. With the procedures costing $150,000 to $250,000, there was concern that private insurers might follow Medicare's lead.
So Abbott set about to rebuild its transplant team. "Heart transplants are like a team sport," said Dr. Kevin Graham, president of the Minneapolis Heart Institute at Abbott. "It's all about having the right people."
The team typically includes several heart surgeons and cardiologists, a nurse practitioner, a nurse/transplant coordinator, a nutritionist, a pharmacist, a physical therapist, a financial adviser and a mental health professional.
After recruiting several experts in the field, Abbott can now focus on treating patients with failing hearts.
An instant bond
When Miller and Linck met at the hospital, they immediately clicked. "Their friendship was a match made in heaven," said Dr. Nader Moazami, a newly recruited member of Abbott's heart transplant team. "It was fortuitous. I have never seen anything like it."
Their back stories were remarkably similar, especially because they're so young. Almost half of the 2,211 patients nationwide who had heart transplants last year were between the ages of 50 and 64, according to the United Network for Organ Sharing, or UNOS.
Miller was born with a congenital heart condition that required two surgeries before her second birthday. In February 2009, she underwent minor surgery and didn't feel right afterward. In August, doctors diagnosed congestive heart failure.
At the time, she was training for a 5K race, so she couldn't grasp that she was seriously ill. But her health deteriorated, and on Dec. 18 she went on the waiting list for a new heart.
Sometimes people die waiting. UNOS data indicate that about one patient on the waiting list dies for every five who receive a transplant, and as of mid-May there were 3,164 people on the heart transplant waiting list nationwide.
Linck was diagnosed at age 11 with hypertrophic cardiomyopathy, a condition that makes it difficult for the heart to pump blood. Despite that, she matured into an active adult who has lived in Thailand, the Dominican Republic, Spain and Argentina.
Last June, she had a hard time catching her breath. Doctors said her heart was failing. "I was told that in one to five years I would need a heart transplant," she said. "But it seemed to come up so fast. I didn't feel ready."
She willed herself to graduate from Northeastern University in December with a 4.0 grade point average and degrees in human services and international affairs. But activity was increasingly constrained. "My stomach always hurt. I always felt bloated" -- a telltale symptom of the fluid buildup in her heart.
By the time she moved into Abbott in February to wait for her heart, she found it difficult to breathe and sleep. Her doctors said she was hours from death. Linck sensed her time was short. As she was wheeled away for her transplant, she recalls wondering: "Will there be a tomorrow?" But she was so sick she didn't seem to care.
Perfect choreography
In Minnesota, a nonprofit group called LifeSource matches donors with those needing a heart transplant. If someone specifies "Donor" on his or her driver's license, or if a family donates organs on behalf of a loved one -- the St. Paul organization is contacted. The sickest heart patients go to the front of the line, said LifeSource spokeswoman Rebecca Ousley.
The donor heart must match a number of criteria in the potential transplantee, including blood type, organ size, even geography. Once an appropriate heart is found, a surgeon removes the organ, packs it in a cooler and rushes it to the hospital where the transplant patient awaits.
According to Dr. David Feldman, the new head of the transplant program at Abbott, the time frame between obtaining the heart from the donor to transplant is about four hours. So it's usually best if the heart is within an hour's distance by air or ambulance.
The popular image of surgeons rushing into the OR brandishing a cooler carrying a heart is "the one medical procedure you see on TV that happens the way it happens in real life," Feldman said. "The cooler really is like the one you had in college to hold your beer."
There's a fascinating kind of ballet to the procedure, with each step perfectly choreographed with the next. "Sewing the new heart in is easy," Feldman said. "It's a timing game, and there's a certain delicacy to the timing. The hardest thing is setting it all up."
Sense of gratitude
Both Miller and Linck have no memory of their surgeries. Transplant recipients are warned that even if the heart arrives safely, there's no guarantee it will be a match. "When I woke up, I wasn't sure I had a new heart," Miller said after her March 31 transplant. The footlong scar on her chest was a telltale clue.
Miller was released from Abbott nine days after her transplant and couldn't wait to snuggle with her dogs, Redneck and J.J. With an education degree from the former College of St. Catherine, she wants to mentor heart transplant patients. She was recently named Minnesota's ambassador for the American Heart Association's Go Red women and heart disease campaign.
Linck's transplant took place Easter morning, a coincidence in timing that she struggles to understand. "I'm not a religious person, but I do consider myself spiritual. When it came on Easter, it was overwhelming."
She was released from Abbott on April 15 with a desire to feel the sun on her face. That, and learn Portuguese and the guitar, hike the Andes and get a master's degree in education.
The two women talk, instant message and e-mail several times a day. They still try to say goodnight every evening. Both must take drugs for the rest of their lives to ward off possible rejection of their new hearts.
When the women feel comfortable, they may contact their heart donors' families through Abbott and LifeSource. Both say they want to.
"I feel an overwhelming sense of gratefulness," Linck said. Her friend nods in tacit agreement: "I want them to know that their loved one is still loved, and goes on living. In me."
Janet Moore • 612-673-7752
