Profiles | Ila May Fisher

Ila May Fisher, who recently underwent a heart transplant, is not your typical transplant patient. Just a couple of weeks after her transplant on December 13, she jogged 2.5 miles and now the 26-year-old is busy making plans for her future.

"I see my heart transplant as a beautiful gift and opportunity and wouldn't take the experience back because it showed me all of the goodness in people," says Fisher. "It also really helped me figure out what I'm meant to do in life."

Once she fully recovers, Fisher plans to attend the Academy of Art in San Francisco, where she wants to express herself and experience through art, maybe even incorporating some of her old medical supplies into her creations. And at some point, she'd like to help other people facing a similar experience.

Fisher's remarkable outcome was not expected. "I was told that I wasn't even supposed to live when I was first diagnosed," says Fisher. "And not only did I make it, but I feel better than I have ever felt. That's why I want to give back what was given to me."

At the age of 18, Fisher was diagnosed with a serious heart condition called dilated cardiomyopathy. This occurs when heart muscle tissue is stretched and enlarged, making it difficult for the heart to function and often leads to congestive heart failure. In September 2004, Fisher suffered from congestive heart failure, as well as kidney and lung failure.

Although a heart transplant was recommended, Fisher's condition was so serious that she didn't have time to wait for a transplant. She was put on a life-saving machine called a paracorporeal ventricular assist devices (PVAD) -- a mechanical device that assists the heart's pumping function. PVADs are either used as a bridge-to-transplant therapy for patients waiting for a heart transplant, or as a permanent therapy for patients who are not eligible for a heart transplant.

Because both sides of Fisher's heart were not functioning properly, she had two PVADs implanted to help support her heart, which is called a BiVAD (biventricular assist device). Although the BiVAD device was keeping Fisher alive, her quality of life was greatly impacted and long-term use of the device is not recommended. Serious complications, such as blood clots and machine malfunctions, which Fisher later experienced, may occur.

So in November 2005, Fisher moved to Minneapolis to be closer to Lakeview Hospital and join a clinical trial for therapy that helps rebuild heart tissue. The goal of the trial was for Fisher to get medication that would allow her heart to function on its own without the BiVAD device, so she would not have to undergo a heart transplant.

But at Lakeview Hospital, when Fisher had her first echocardiogram (ECHO) test -- a test that translates sound waves from the chest into pictures of the heart to see how well the heart is pumping -- her heart was barely functioning on its own. The test revealed that her left ventricle was enlarged, her heart valves were leaking and the walls of her heart were barely moving.

Because of the condition of her heart, which Fisher describes as "big, baggy and weak," she was not eligible for the clinical trial and was told that a heart transplant was her only option.

The heart transplant wait list at Lakeview Hospital was two years, compared to five months at UCSF Medical Center, so Fisher decided to go back to UCSF for her transplant. She also wanted to receive care from her old team of nurses and doctors, including Dr. Donald Hill and Dr. Charles Hoopes, who performed her BiVAD surgery.

"Ila's recovery after transplant has been remarkable and is in large part the result of her mental toughness and her capacity to deal with the physical and psychological stress associated with long term VAD implantation and removal," says Hoopes, a renowned specialist in surgical coronary revascularization, heart transplantation, valve repair and valve replacement.

While in Minneapolis, Fisher received a phone call from her doctors at UCSF, who promised her they'd find her a heart. However, because of the high level of antibodies in her blood 97 percent finding a compatible heart for Fisher would be extremely difficult. In order to receive a transplant, Fisher's antibody level, known as PRA, had to reduce to 20 percent.

As soon as she returned to San Francisco, Fisher was admitted to UCSF where she began treatment with plasma apheresis, a blood cell separator method that collects plasma from a patient and exchanges it with plasma from a donor in order to reduce the PRA level. During her very first treatment, Fisher was told that a potential heart was found and her PRA level had decreased to 18 percent from 97 percent, making her eligible for a transplant.

After only five days on the transplant wait list, Fisher underwent a heart transplant, performed by Hoopes. "I was so scared before my transplant, but all of the doctors and nurses came in and assured me that everything would be alright," says Fisher. "One of my nurses and my VAD coordinator even stayed in the operating room the whole time to be sure everything went okay."

Fisher's transplant was considered high-risk because of the long period of time she had spent on the BiVAD machine and her originally high PRA level. However, her surgery was a success and Fisher was able to walk the very next day.

"Now I feel like this is the heart I'm supposed to have; my old heart was so heavy and I was always conscious of it," says Fisher. "Before I was always thinking about how much time I had left. Just to be able to breath without having a machine attached to me is so much to be thankful for. I feel like I have a whole new life and I'm so grateful."

Story written in January 2006.

Abby Sinnott is a freelance writer who lives in San Francisco.