Last modified: 11 May 2000
Should heart transplantees be put in a special category when competing in the Transplant Games? I thought the answer was obvious, but on reflection perhaps not. Here are some of the pros and cons.
The operation itself requires a splitting of the sternum which is then joined by steel wire. Although the bone does heal after a few months, it's still thought that contact sports should be avoided because of a potential weakness. The operation, of course, consists of removing the old heart, leaving the sinoatrial node, which should join with the nervous system of the new heart. Whether it does join up with the new heart's nerve fibres or not is, I understand, in doubt.
What has all this got to do with the Games?
The immediate response to exercise is carried by nerve impulses from our brains into the heart. This causes the heart to speed up when its work is needed. If the nerves are disconnected, then the heart can only respond when adrenalin reaches it. Its response is dependent on circulating chemicals in the blood, (adrenalin and other) not on a direct nervous impulse. The conclusions of Gorges Niset, MD, Physiotherapy, Brussels, in his Vade Macum Heart Transplant Patients' Handbook is that with heart transplant patients, the heart rate at the end of standard tests is usually lower than the predicted value for a control group matched for age, etc., who have not had transplants. In a proportion of transplanted patients, oxygen uptake may be less efficient.
How does this translate itself into actual physical capability? Well Terence Kavanagh, MD, Toronto, has demonstrated that patients who have had heart transplants can jog 20km a week or more. In my case, when I was 60 years old I covered the 6.5km each training day, in 48 minutes four times a week and ran the annual Brussels 20km several times in just over three hours. Obviously training is vitally important as well as the will to win.
But the proof of the pudding is in the eating. At the recent British Games which is open to all organ transplants, gold medal winners of the 400 metres under 35 and over 45 years were both heart transplants, the former also winning the 1,500 metres. Again, the Victor Ludorum with five medals, mostly gold, super veteran sprinter, 100 and 200 metres was a heart transplant. In other skilled sports such as tennis, badminton, table tennis, golf, etc., the heart transplants do very well.
This brings me to my conclusion. It would seem that despite some conflicting evidence, heart transplants can compete very favorably, and do, against those who have had kidney, liver, lung or bone marrow transplants. I believe therefore we should continue on an equal footing, both in the National Games and in the World Games.
As you know from the last publication, the European Heart and Lung Transplant Federation is responsible for the European Heart and Lung Transplant Games. This takes place in alternate years to the World Transplant Games. Next year, July 1998, it will be in Germany at Bad Oeynhausen. Many European countries want to continue these Games, which are very friendly and perhaps less competitive than the World Games. I believe that there is a need for both. This will mean more publicity for the main purpose of our activity, which is to ensure the continued availability of donors and awareness and favorable attitude of the public that transplantation is a good thing.
Last modified:
11 May 2000