MARIA ORTIZ, HEART TRANSPLANT SURVIVOR Written and photographed by June Grayson In November, 1988, two teen-age classmates from Clemente High School in Chicago lay dying in the intensive care unit of Illinois Masonic Hospital. Auri Rodriguez had a rare neurological disease that would soon prove fatal. Maria Ortiz had end-stage heart disease caused by cardiomyopathy, a disease of the heart muscle. Without a new heart, she had no hope of survival. Her doctors had already placed her name on a waiting list for a donor heart. Auri Rodgriguez did die last November, but her healthy heart did not. Auri's mother can take comfort in knowing that the death of her beloved daughter brought a better life to someone else. Because of the ultimate gift - the donation of a healthy heart - Maria Ortiz now lives through the miracle of organ transplant surgery. Maria Ortiz was born of Puerto Rican parents in Chicago in 1970, a normal baby, seven pounds, ten ounces. She does not know the cause of the heart disease that developed when she was six months old. "Ever since then, I had to take Lanoxin for my weak heart but I could do everything the other kids could do," Maria says. She finished her sophomore year in high school and always got good grades. Algebra was her favorite subject. When she became pregnant in September, 1987, she quit school. She was too weak to walk. She had difficulty breathing. Her doctors said the physical stress of pregnancy was too much for her heart. "I could have had an abortion. I never even considered that. I wanted to have the baby." Delilah Marie weighed four pounds when she was born in June, 1988. She had to be in an incubator for three weeks. Maria's mother and two sisters cared for the baby because Maria was too sick. "Even after delivery my heart stayed bad. I had to have gall bladder surgery in July. I went in and out of the hospital with headaches, weakness and shortness of breath." Another emergency hospital admission on November 4, 1988, found her near death. The helpless mothers of the two dying girls met that November in the hospital waiting room. Because Auri's mother had opted for organ donation, a mechanical respirator continued Auri's heart and lung function even after all brain function had irrevocably ceased and she was legally dead. Without oxygen, body organs deteriorate swiftly and cannot be used for organ transplants. Carmen Geliga, Maria's mother, prayed for a miracle. "I could not bring myself to come right out and ask the other mother for her daughter's heart. That would have been too cruel." Auri's mother made her own decision. "I want to donate my daughter's heart so your daughter can go on living," she told Geliga. Nationally, The United Network for Organ Sharing matches available transplant organs with lists of waiting recipients. "The hospital did not follow the usual protocol for this patient," Candice Wyberg, organ procurement coordinator explained. "The mother had specifically designated that Maria was to receive the heart and may have changed her mind if her request had not been followed." Doctors determined that the heart would be a good match for Maria. Blood types were compatible. Auri did not have acommunicable disease such as hepatitis or AIDS. The two girls were transferred to the University of Illinois Hospital for the procedure. Two organ transplant teams headed by Dr. Windsor Ting, cardiac transplant surgeon, and Dr. Pedro del Nido, pediatric cardiac surgeon, worked in adjoining surgical rooms to remove the healthy heart from Auri and insert it into Maria's chest. Incredible as it may seem to outsiders, surgeons no longer consider heart transplantation a technically difficult procedure. The few blood vessels that have to be connected are large and easily sutured. Liver transplant surgery, by comparison, involves many small blood vessels and is not yet as successful as heart transplant surgery. Dr. del Nido observes, "Survival statistics for heart transplant patients get better every year. Chicago even has a working surgeon who had his own cardiac transplant surgery thirteen years ago." The University of Illinois Hospital did seventeen cardiac transplants in 1988 and fifteen of them survived. All are doing well. Maria was the second youngest patient to have a heart transplant at the University of Illinois. Approximately 150 medical centers in the United States now perform heart transplants. Ninety percent will survive one year and sixty five percent five years. According to Sue Miller, R. N., transplant coordinator at the University of Illinois, Chicago, "Patients do not always achieve an idyllic existence. Sometimes they just exchange one set of problems for another. Yet most patients think the gamble is worthwhile." Organ rejection remains a life-long concern. According to newspaper reports, such rejection was a contributed to the recent death of Donna Ashlock, another heart transplant patient in Patterson, California. Maria takes seven medicines daily, among them cyclosporine to prevent organ rejection and an antibiotic to prevent infections. She must return to the hospital every four weeks indefinitely for out-patient evaluation. Medical researchers hope to develop a totally artificial implantable heart. Such a heart would avoid the danger of organ rejection and make live organ transplants obsolete. For now, the present artificial heart serves as a bridge machine to keep heart patients alive until a donor heart becomes available. For Maria, the miracle continues. "I felt better right away. I have more energy and I can do everything." Her mother, who took a six-month leave of absence to help Maria, has returned to work. Maria has moved into her own apartment. "I can do my own housework. I take care of my baby. We take long walks." She plans to return to night school to get her high school diploma. She would like a career, or at least be able to get any work at all. She dreams of a better life for her daughter, little Delilah Marie. "I hope that she will have a good education, a career, and a happy marriage." She dreams for herself. "I hope that the rest of my life will be easier than it has been so far." ##### For more information about organ sharing, call 1-800 24 DONOR, the 24 hour number of UNOS, The United Network For Organ Sharing.