science
Drs. William Pierce and John Pennock Implant the Penn State pneumatic heart in
Heart not always
By KATHI DODSON
and CHRISTINE KILGORE
Collglan Science Writers
Implanting the Penn State pneu
matic artificial heart in Robert Cres
swell, after his body had previously
rejected a human donor heart, may
not have been'an appropriate applica
tion of the artificial heart, said John
Pennock, associate professor of sur
gery at the University’s Hershey
Medical Center.
“It may well be this situation is not
an acceptable situation to use the
heart .. . where the patient has re
ceived a transplant and the trans
plant fails,” Pennock said at a press
conference yesterday. “That depends
on why the transplant fails, but if it
fails because of rejection, I think that
tells you something about the pa
tient.”
Cresswell, who received the Penn
State heart after his body rejected a
human donor heart he had received
seven days earlier, is highly likely to
reject a foreign heart because he has
an unusually high antibody count,
Pennock said.
Device may replace
PSU artificial heart
By CHRISTINE KILGORE
Collegian Science Writer
An electric artificial heart, now
being developed as a long-term or
permanent replacement for defective
hearts, may someday replace the
Penn State pneumatic artificial
heart, according to one of the electric
heart’s developers.
David B. Geselowitz, a University
professor of bioengineering and med
icine, said the,electric heart can be
contained completely within the body
and does not require the bulky exter
nal power unit that must be used with
the Penn State pneumatic artificial
heart the device now pumping
inside Robert Cresswell’s chest.
While the pneumatic, or air-driven,
heart is operated by an external
compressed-air pump, the electric
heart is operated by a small electric
motor, Geselowitz said. And the bat
tery required to power its motor can
be carried by the patient, allowing
extra mobility.
“Aside from a battery pack, the
electric heart would be essentially all
implanted inside the body,” Geselo
witz said. “With the air-driven heart,
you’re connected to a bulky motor
unit it leaves something to be
desired and is just not practical. An
electric motor replaces large pneu
matic devices and gives the patient
much more mobility.”
Geselowitz, a leader in the cooper
ative artificial heart research effort
between the University’s College of
Engineering and the College of Medi
cine at the University’s Hershey Med
ical Center, said two separate
electric motor devices are now in use.
The electric assist device is used to
help one of the heart’s chambers
pump blood, giving the heart time to
heal, he said, adding: “This is used in
a situation where the natural heart
can’t function adequately. It is used
in conjunction with the natural ven
tricle and often takes over a good part
of the function of the heart.”
On the other hand, the electric total
heart replaces the patient’s heart
rather than assisting a heart that has
failed to function.
Like the motor driven devices, air
driven devices now used also include
a ventricular assist device and a total
artificial heart recognized as the
Penn State* heart. But while both
types of air-driven devices are only
used temporarily, Geselowitz said
researchers hope that the electric
“We have located four or five or
gans that were compatible in blood
type with Cresswell over the past five
or six months,” Pennock said, adding
that Cresswell has been on the trans
plant list since May 12.
But since Cresswell’s unusually
high antibody count greatly increases
the risk of donor heart rejection, a
very close match between Cres
swell’s blood protein and the donor’s
protein must be made. Dr. Victor G.
Rohrer, associate dean for patient
care at the medical center, said such
a precise match can be very difficult
if not impossible.-
Pennock said Creswell’s high anti
body count is a result of several
factors, including his previous donor
heart rejection and numerous blood
transfusions given to Cresswell dur
ing earlier regularjieart surgery.
“When you get a foreign tissue in
the body, which is what a blood trans
fusion is, your body builds up antibo
dies to these cells,” Pennock said.
“Cresswell has very high levels of
these pre-formed antibodies.”
“We know from doing statistics
that probably one in 100 hearts would
‘The total electric
heart has sustained a
calf up to 222 days.’
David B. Geselowitz
heart is what may someday become a
permanent Penn State heart.
“The pneumatic system whether
used as a total replacement or assist
is always used on a temporary
basis,” he said. “However, there are
clearly patients who need it perma
nently. That’s why we’re working on
the electric heart ... the ideal solu
tion is for the electric heart to be used
permanently.
“The total electric heart has sus
tained a calf up to 222 days,” Geselo
witz said, adding that use of the
electric heart in humans is still a few
years away. “We have also tested the
assist devices, but none of them have
sustained calves as long as the total
electric heart has.”
The motor-driven heart, like the
pneumatic heart, is a rigid plastic
case surrounding a flexible plastic
sack, he said, adding that the differ
ence between the two designs is the
pumping mechanism.
In the motor-driven heart, the elec
tric motor mechanically forces a
pusher plate to apply pressure to the
inner flexible sack and force blood
out of the heart chamber, he
said.“ The motor is a brushless direct
current motor with permanent mag
nets,” Geselowitz said. “And recent
ly, science has developed more
powerful magnets. This essentially
means we can reduce the size of the
motor.”
“The patient would have to re
charge the batteries on a daily ba
sis,” he said. “But the patient would
be able to go on his way sooner."
Although researchers hope the
electric heart can be used as a per
manent device, it may also have
advantages over the pneumatic heart
as a temporary device, Geselowitz
said. “It may have superior qualities
... maybe we’ll just abandon the
pneumatic heart someday that
remains to be seen.”
Geselowitz said major funding for
the University’s artificial heart re
search program, which began in 1970,
has come from the National Institute
of Health and the National Heart,
Lung and Blood Institute.
Robert Cresswell on March 17,1986.
solution
be compatible,” Pennock said, add
ing that the medical center would
have to be offered 100 donor hearts
before they found one that matched.
To find a compatible donor, the
medical center relies upon the Dela
ware Valley Transplant Program
based in Philadelphia. Howard Na
than, director of the DVTP, said
possible transplantable organs are
found through a network of 166 hospi
tals in the tri-state area. Organs
cojne from patients who are brain
dead, having suffered total and irre
versible destruction of the brain.
Heart donors must be less than 35
years old and weigh within 25 to 30
pounds of the recipient’s weight. Sim
ilar sizes between donors and recipi
ents is necessary to assure that the
heart is large enough.
Any possible donor heart must be
within a 3M-- to four-hour flight from
Hershey. All organs, but especially
hearts, can only be preserved for a
limited amount of time once the do
nor has died. Therefore, the number
of transplants that can be completed
in an area is limited.
The Penn State Heart is covered with velour to improve the heart’s attachment to tissue and uses plastic cardiac valves'to control blood flow.
So, just how safe is your water?
It’s dead,
When the 99th Congress ad
journed Saturday, a bill, which
would provide money to keep the
Superfund program in business for
another five years, breathed its
last.
As our faithful legislators headed
for some last-minute campaigning
before the November elections, the
Superfund bill sat unsigned on Pres
ident Reagan’s desk. And so it went
the way of all bills lacking a presi
dential John Hancock at the end of a
session to the circular file.
The federal Superfund was estab
lished in 1980 to help clean up the
toxic messes left by chemical com
panies. Many Superfund cases, like
the Drake Chemical Company site
in Lock Haven, involve waste
dumps that were simply abandoned
by their producers, leaving local
Heart
Continued from Page 1.
there is a tugging on the line. Some
times (the tubes) stay clean, and
other times they don’t.”
Anthony Mandia, the first recipient
of the Penn State heart, lived for 11
days with the heart before receiving a
human donor heart. He died 17 days
later from complications linked to an
infection.
Doctors at Hershey have made it
clear that the pneumatic heart is used
only as a temporary bridge until a
transplantable donor heart can be
found for a patient. However, if no
suitable donor heart can be found, the
patient must remain on the heart.
“There’s no other choice,” Pennock
said.
“When we first embarked on this
program, people asked what happens
if a patient ends up on the device for a
long period of time we don’t consid
er that ideal,” Pierce said. “ The
nicest thing is to be able to put the
device in for a period of a few weeks
or a month and then be able to do the
transplant.”
Cresswell’s unusually small appe
tite has also caused concern among
his physicians. "I would like to see his
appetite better ... we have at times
had to use a small feeding tube,”
Pierce said. “If he does not take 2,000
calories a day, he has to be supple
mented (through the use of feeding
tubes).”
Cresswell’s other body systems
have been functioning well, he added.
“After the heart was put in, (Cres
swell) went 40 days with virtually no
urine input ... he had received kid
ney dialysis every day during that
time. But he has not required daily
dialysis for a long time,” Pierce said.
Geselowitz said in addition to possi
ble infection around the heart tubes,
blood clot formation originating near
the heart valves is another risk of
using the artificial heart.
“(Patients have had) strokes
caused by a blood clot that lodges in
the brain,” Geselowitz said. “Almost
certainly, it is coming from the artifi
cial heart, although it is hard to say
what is happening.”
“Problems occur when anything
comes in contact with the blood. In
this case, the problem is primarily
the heart sac,” he explained. “In the
sac itself, a deposition of material
occurs in a single region where there
is not a constant flow of blood. If there
is sufficient build-up, a particle can
break off and block a vessel.”
residents holding the toxic bag.
In fact, Superfund was one of a
few good things to grew out of the
Love Canal tragedy of the 19705.
In the case of Love Canal, a
spanking new housing project was
built over an abandoned waste
dump. Several years after people
began living over the decaying bar
rels of waste, residents began re
porting rare forms of cancer and an
alarmingly high birth defect rate.
When the investigations started,
residents found that the company
responsible for their toxic night
mare had long since gone out of
business and there was no one to
relocate them, clean up the mess,
or compensate them for their suf
fering. Fortunately, the Environ
mental Protection Agency stepped
in.
That was a different era for
America.
However, the original Superfund
bill expired over a year ago and
although Congress has voted to
reauthorize the EPA directed pro
gram, but the legislators haven’t
coughed up the money except in
small, stopgap doses.
In a Science News article last
week, EPA Administrator Lee M.
Thomas said, “virtually no new
work has been started for months,”
adding that Superfund’s emergency
Drs. William Pierce and John Pennock, shown here, are the attending physi
clans of pneumatic heart patient Robert Cresswell.
During the day, Cresswell rides a
stationary bicycle, sits in chair,
walks a little, and does,arm exercises
to keep up his strength.
“I don’t feel too bad I feel al
right,” he said in an interview last
week. “I can sit up and then I walk a
little.” He added that he also enjoys
putting together a model engine that
should run when completed.
Faith Cresswell, who visits her
husband every day, said he enjoys
watching movies on a videocassette
recorded in his room. “His favorites
are old Westerns and wrestling he
is crazy about wrestling,” she said.
“And he likes his nurses they flirt
around a lot.”
She added that Cresswell has not
received many visitors or mail lately
and that he had expressed his hopes
for some visitors last Sunday. His
children visit him every two weeks
along with visits from his pastor and
doctors.
John Vastyan, a hospital public
relations spokesman, said earlier this
month that once a week, Cresswell
moves from his room to a conference
room, where he eats lunch with his
wife, nurses and physicians.
“He is moved in a wheelchair . ..
moving is an easy thing to do now and
.Ij£. ■
response program is operating at
only “a drastically reduced level.”
If another Love Canal, with hun
dreds of families involved, were to
surface today, the EPA would be
virtually powerless to help.
Why? Basically because the Rea
gan administration doesn’t believe
Superfund is money well spent.
With less than two weeks left in
the session, House and Senate bi
partisan negotiators came up with a
compromise bill, giving Superfund
$9 billion over the next five years.
Environmental groups lobbied
for up to $l5 billion because the
EPA needed strong financial sup
port if it hoped to make a dent in the
more than 20,000 waste cleanup
cases throughout the nation (some
1,000 cases in Pennsylvania). How
ever, the EPA would have been
happy to make due with $9 billion
it’s better than nothing.
Reagan, however, wouldn’t sup
port any bill over a meager $5.3
billion. And to avoid the veto over
ride Reagan knew would follow
nixing Superfund, the president
simply chose to let the bill suffocate
under a stack of paper on his desk.
Sure, Congress can come back
and draft, another Superfund bill
next January. But the legislative
process, including (presumably) a
veto override, could take six
The Daily Collegian
Thursday! Oct. 23. 1986
it’s something he likes.” Vastyan
said. “This trip outside the room is
very important.”
However, Faith added, he still suf
fers from depression. “Emotionally,
he gets different levels of depression.
He-used to be happier ... he used to
smile and joke more,’’she said, add
ing that the death of other artificial
heart patients has upset her husband.
“We can’t do anything about it
we can’t go any farther until we get
that heart,” she said. “I (too) have
my ups and downs, but I know I have
to keep strong for him,” she said. “I
love him and I’m committed... once
you’ve started something like this
you can’t stop.”
“If everyone would say a prayer
that he gets a donor heart ... that
would be the best thing they could do
for us,” she said. “And it’s not just
my husband who needs a heart
there are a lot of people out there who
need vital organs to live.”
Faith said a trust fund established
in Huntingdon is helping finance her
husband’s medical expenses, which
surpass $150,000.
“Medical assistance would only
pay for a third of the cost we’ve
gone way above that now,” she said.
“I don’t know what is going to hap
pen.”
months six more months of
Americans coping with a toxic
nightmare with no one to help.
Okay, so the President doesn’t
care about the environment, includ
ing our abundant supply of drinka
ble water. But what about the
health and safety of the people
living on and around these aban
doned toxic waste dumps? Obvious
ly not a priority in Mr. Reagan’s
book. It’s like hunger in America
deny it long enough and the prob
lem’s bound to go away. Or maybe
Mr. Reagan cares more about the
political ideology of Central Ameri
ca.
But don’t take my word for all
this. Take a drive out Route 26
toward Lemont. There’s a little
brook a short hike up from the road
that feeds the Spring Creek.
That sweet odor you smell is
Mirex a cancer-causing chemical
that leaked from a State College
company’s holding lagoon and con
taminated the groundwater and, by
default, the creek. Fortunately, the
luck of the geology saved the area’s
drinking water, this time at least.
Nan Crystal Arens is a senior
majoring in Earth science and tech
nical writing and is a science col
umnist for The Daily Collegian.
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Penn
State
State Food Service announces a convenient and low
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The Penn State Diners Club is a prepaid food service plan
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(both In the dining halls and the cash operations),
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Club membership is open to faculty, staff and students who do
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Don't miss out on the opportunity to enjoy the best for less.
Join The Penn State Diners Club today!
For Further Information Contact:
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Diners
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PizzaTT North
(Heritage Oaks. Toftrees &
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231 E. Beaver Ave. expires 10/23/86 1786 N. Atherton
234-0182 one coupon per customer 238-2220
The Daily Collegian Thursday. Oct. 23, 1986—3
Z 23 Tf i
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