Successful Heart Transplant After Cardiogenic Shock

John Buchholz, a 59-year-old from Kiel, does not seem like a typical heart transplant patient. Before his heart issues developed, he ate healthy and ran every day before work. But in November 2022, he noticed he was short of breath. He went to an urgent care facility, thinking he had pneumonia. A few days later, his legs began to swell, and his cardiologist sent him to a local emergency department. 

Cardiogenic Shock Leads to Heart Transplant

John was in cardiogenic shock, meaning his heart function had declined and was not sufficient to pump adequate blood flow to his vital organs. Typical medications and treatments would not be enough. He needed a new heart.

John was transferred to Froedtert Hospital, the academic medical center of the Froedtert & the Medical College of Wisconsin health network. He went directly into the intensive care unit, where he stayed for the next 70 days. 

“That’s where the fun began,” John said, his sense of humor shining through a difficult time. “I was worried about what was ahead.” 

But John’s story is a good one, thanks in part to the Froedtert & MCW Comprehensive Heart Failure and Transplant Program team that worked to keep him alive and support his wife, Sandy. 

Impella Device While Awaiting a Heart Transplant

Because a donor heart was not immediately available, Lucian “Buck” Durham, MD, PhD, cardiothoracic surgeon and MCW faculty member, implanted an Impella^® device, a rotary pump that works like a small jet engine to move blood through the heart. The device took some of the pressure off John’s weak heart. 

“The Impella device is one of the most effective ways to ‘bridge’ a patient waiting for a heart transplant,” Dr. Durham said. “It is also used to support patients who have a heart attack or arrhythmia, allowing the heart to recover. It’s a temporary solution, with most patients staying on it a few weeks to a month.” 

However, John began to develop other health problems, including complications with his kidneys. He began dialysis.

Enter Eugenia Raichlin, MD, advanced heart failure and transplant cardiologist and MCW faculty member. As John rebounded with the help of dialysis and his kidneys regained functioning, Dr. Raichlin worked to place him on the transplant waiting list in January 2023. In early February, a donor heart became available. 

“I wanted John to have every possible chance to receive a heart,” Dr. Raichlin said.

Expert Care Before, During and After a Heart Transplant 

“A lot of behind-the-scenes work occurs before a heart transplant,” said Takushi Kohmoto, MD, PhD, a cardiothoracic surgeon and MCW faculty member who ultimately performed the transplant. “The sickest patients are typically at the front of the line for a transplant, but they also must meet stringent transplantation guidelines to ensure the best possible outcomes. 

“Anyone evaluated for a heart transplant must go through an extensive review process to ensure the greatest chance for success, as that best honors the donor’s precious gift.” 

John remembers entering the operating room with high hopes tempered by trepidation. When he woke up from transplant surgery, his hopes had been realized. 

“I felt good and had no pain,” he said. “I thought, ‘This heart really beats like it’s supposed to beat.’” 

Comprehensive Heart Failure and Transplant Program

Dr. Kohmoto said the science of heart transplantation is constantly improving, with new treatments and better immunosuppressant medications. 

A team within the Comprehensive Heart Failure and Transplant Program ensures that patients are diagnosed and start treatment quickly upon arrival. 

“In addition to our expert transplant doctors and transplant coordinators, our team includes many other specialists who have worked together for many years,” Dr. Kohmoto said. “Our experienced, collaborative staff are a major strength of our program.” 

John and Sandy concur. John is back to climbing trees and working at the couple’s lavender farm, Country Lavender & Orchard. They see their five children and nine grandchildren regularly. Life is good again. 

“I think if I had been anywhere else but Froedtert Hospital, my outcome may have been different,” John said.

For nearly four decades, our Comprehensive Heart Failure and Transplant Program has provided excellent results for patients. Learn more about the program at froedtert.com/heart-transplant.