Utahn survives 18 heart attacks, 'monumental' life-saving dual transplant surgery
Tom Smart, Deseret News
MURRAY — Waking up healthy every day "still seems like a dream" for one West Jordan man who experienced up to 18 heart attacks in the past nine years, the first at age 22.
"There were a lot of challenges like never knowing when I would have my next heart attack, or never having a cure," said Michael Mader. "Sudden cardiac death, I mean, it just takes one or two heart attacks to take you out."
Thanks to organ donation, Mader, who was diagnosed at age 3 with a rare genetic liver disease, now has a new lease on life.
About a month ago — after 718 days on a waiting list — he became the state's first adult to receive a combined heart and liver transplant on the same day at Intermountain Medical Center.
"It was the best gift anyone could receive," Mader said Thursday. "It saved my life."
The now-31-year-old IT guy had lost track of how often his heart didn't do its job. He was physically limited as a child, tired more quickly than his peers and has followed a low-cholesterol diet all his life, which has been dotted with surgeries and plentiful medications.
Mader, who suffered with familial hypercholesterolemia, had more stents placed in his old heart than years of his life lived.
"He's been quite sick for some time," Dr. Deborah Budge, Mader's cardiologist at Intermountain Medical Center's Heart Institute said Thursday. His original liver damaged his heart by not efficiently metabolizing cholesterol, which led to blockages in the heart.
Both organs needed replacement for his body to have a chance at functioning properly. Before the April 23 transplant, his cholesterol level was well over 500. It settles around 140, a normal level, now.
At one point, Mader had been told to "set his affairs in order" and prepare for death, said his mother, Susan Nab. She said he is now happy to report "that he's planning for retirement."
Nab, who has endured seven-artery bypass surgery herself, said her children each had a 1-in-3 chance of being born with the disease, which runs in her family. She has had a grandfather die from it in his 20s and also lost a mother and sister to heart attacks.
Other family members are afflicted, but Mader's case is the worst they've seen.
"He's never had any prognosis that was anything but poor," Nab, of Lewiston, Idaho, said through tears. "Michael has been held back his whole life by heart disease."
Dr. John Doty, a cardiovascular and thoracic surgeon at Intermountain who performed Mader's heart transplant, said the nearly four-hour surgery couldn't have gone better.
"We have a young man sitting here who has had the gift of two organs from some family that was kind enough to give that gift of life," Doty said. "He looks terrific. If you passed him on the street, you wouldn’t know he’s had a transplant."
He said more than 200 physicians and hospital personnel played a part in Mader's treatment and transplant process.
Because Mader's condition is so unusual, the dual transplant had only been completed in the western region of the United States 10 times prior to Mader's, said Dr. Willem Van der Werf, a surgeon at Intermountain. Many patients with hypercholesterolemia, he said, don't live into adulthood.
The team knew of only one other Utahn waiting for a similar procedure.
Van der Werf, who transplanted Mader's liver, said the organ served as gene replacement so the new heart could survive.
"From a medical and surgical perspective, it all went according to plan," he said.
In the last 20 years, only 132 combined heart and liver transplants have been performed on adults and children in the U.S., according to the United Network for Organ Sharing. Only 11 of the dual transplants have been performed within the UNOS-designated region of the country that includes Utah, Arizona, California and New Mexico.
The first of its kind performed on a child in Utah was done at Primary Children's Medical Center last year.
Salt Lake City-based Intermountain has one of the most successful organ transplant programs in the country, boasting a 100 percent survival rate for the past three years, according to Dr. Kent Jones, a surgeon who participated in the organization's first transplant in 1985 at LDS Hospital and retrieved the heart that ended up in Mader's chest.
Jones said innovative procedures, like Mader's, opens the door to other patients looking for options for survival. He said pulling off the two complicated procedures is "monumental."
Mader was released from the hospital on May 6, already feeling better. He said he almost instantly had more energy, isn't short of breath, sleeps better and thinks more clearly.
Like any mother might be, Nab is proud of her son for holding on so long. She couldn't bear the thought of losing a son so young.
Not long ago, she said he was unable to carry a basket of his own laundry or make it across the street before the light would change, but he's now able to do all that, as well as date and plan for a pain-free life ahead.
"He is going to be set free," Nab said. "It's like having the whole world in front of you. It wouldn't be possible without organ donation."
Mader already enjoys increased levels of physical activity, looks forward to travelling more, as being on the transplant list kept him close to home, and finishing school so that he can "meet goals and be a normal person for once," he said.
He's also hoping to someday beat his younger, marathon-running sister in a foot race.
"I'll still be watching my diet closely. I want to be as healthy as I can, but there shouldn't be any limitations like there were before," he said. "Doctors say I could run a marathon if I wanted."
For the first time, in as long as he can remember, the now vibrant man said he is "looking forward to a healthy life."
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