Sam Hiscoe was so sick that he couldn’t walk around his house without dry heaving; he was always pale, and his lips were gray.
His condition, hypertrophic cardiomyopathy or HCM, is a genetic disease that creates thick, stiff heart muscle, restricting the heart’s ability to pump blood to the rest of the body. His doctor told him he would need a heart transplant.
“My doctor said, ‘You’re going to Tufts Medical Center, you’re not going anywhere else,’” said Hiscoe, 36.
He was admitted on April 10, 2024, and spent 55 days in the hospital awaiting a new heart. On June 4, Sam received a new heart, one of a record-breaking 70 adult hearts transplanted at Tufts Medical Center last year.
“It’s a night and day difference,” said the Maine resident. “I wake up feeling completely different. My whole body was just like ‘thank you,’” he said. “Overall care from the staff, I can’t even tell you how great they were. They were in tune with the care not only for me but for the people who were with me.”
Partnerships build pathways to care
The team of specialists at the Medical Center’s Advanced Heart Failure and Cardiac Transplantation Program achieved a milestone in 2024 by transplanting more adult hearts than any center in the New England region and breaking its own previous record set in 2023. How did the Medical Center become one of the nation’s most successful and highest-volume transplant centers?
Dr. James Udelson, Interim Chief Physician Executive of The CardioVascular Center and Chief of the Division of Cardiology at Tufts Medical Center, attributes much of the success to a focus on building strong relationships with other hospitals throughout New England. These care centers perform all necessary tests and pre-transplant evaluations, saving patients from traveling to and from Boston. When the time comes, patients are sent to the Medical Center, where a team of transplantation experts performs the surgery.
“We essentially have partners at all these places around New England, which is a model other people do not do,” said Dr. Udelson.
Care partners extend from the southern-most regions of New England to the Canadian border of Maine.
“These pathways offer patients across New England access to the advanced care available at Tufts Medical Center while maintaining a vital connection to their local cardiologists, who collaborate closely with us throughout the transplant evaluation and management process,” said Sharon Klarman, Executive Director of Solid Organ Transplant. “The success of our program is rooted in the partnerships we have with our shared care centers and their dedicated staff, whose collaboration is integral to achieving these outcomes”
These relationships are strengthened by the long history the Medical Center has with heart transplants and advanced heart failure, said Klarman. The transplant program began in 1985, and has performed 820 transplants in the last 39 years. Read about the first Tufts Medical Center Heart transplant recipient.
“The program is bigger in volume and quality than all the other hospitals in the region,” said Dr. Udelson. “We’re a moderate size—we punch above our weight in a number of areas like transplant.”
Access, support and better outcomes
“The volume alone is impressive, but what we’re most proud of are the outcomes, which truly reflect the exceptional collaboration and expertise of our entire team,” said Klarman. “Caring for critically ill patients requires a coordinated and dedicated effort, and achieving 100 percent survival for 70 patients is a testament to the strength of that collective commitment across dozens of specialty services here.”
Having a network of care centers has increased volume and added another benefit—shorter wait times for hearts.
“I think the most important thing is people are not spending time waiting for a heart because our transplant list is long,” said Dr. Indranee Rajapreyar, Medical Director of Cardiac Transplantation. “They’re not having to wait years; we’re able to get sicker people to transplant quicker.”
Lori Aho, 53, was also among the 70 patients who received a new heart last year. Diagnosed with congestive heart failure in 2016, Aho had a history of heart failure in her family. Her grandfather and uncle both died of heart failure at age 58.
In December of 2023, after Aho finished dinner, her Implantable Cardioverter Defibrillator (ICD) went off 6 times in 10 minutes, indicating her heart was in an abnormal rhythm and “beating out of control.” An ICD is a small device implanted in her chest that delivers an electric shock to get her heart beating regularly again.
Her husband called 911, and she was brought to Lowell General Hospital. The next day she was transferred to Tufts Medical Center and was added to the transplant list. Then, the day after Christmas, she was moved to the top of the list as her condition deteriorated, and by January 3, 2024, she had a new heart. She said even the nurses were surprised at how fast she got a heart.
Aho, who lives in New Hampshire, said that while her recovery has been slow going, she always feels listened to, and the care includes everything from “soup to nuts.” If she has a question, she reaches out to her doctors through the myTuftsMed patient portal and usually hears back within an hour.
“I think Tufts Medicine is top-notch, and the care goes beyond expectations,” she said. “I wouldn’t hesitate to tell anyone in my condition to go.”
The support Aho receives is a cornerstone of the program, and the care team continues to stay invested even after patients leave the hospital.
“The care we provide doesn’t end at discharge. Once a patient is transplanted, we remain actively involved in their care for life. Our team continues to collaborate closely with local care providers to ensure seamless communication, ongoing monitoring, and comprehensive support. This lifelong partnership allows us to address any post-transplant needs while maintaining a strong connection to the patient and their local healthcare team,” said Klarman.
Dr. Rajapreyar said Tufts Medical Center’s entire team is deeply invested in the care of their patients from before they ever enter the hospital.
“It’s a personal connection that I have seen everyone, not just the group of physicians, the nurses in outpatient, it’s in the hospital, every physician, the nurses, the social workers, and the respiratory therapist,” she said. “Everyone who comes into contact with the patient they have this investment. It’s not just about checking off boxes; it is a different level of involvement.”
The program’s Linda Ordway, NP, Clinical Lead NP Advanced Heart Failure, said each patient is cared for holistically, meaning the staff tailor treatment based on every individual’s experiences and circumstances. They consider what the care means for the patient and their family because “we’re their family when their family can’t be there.”
“Living in the hospital and the burden it puts on families…to know that we’re caring for them, and we’re taking care of not just their vital signs and all that, but we’re taking care of their spirit and giving them support and letting them talk about their fears,” she said. We’re taking care of their mind, body and spirit.”
That personal connection is a lifeline for Hiscoe, who now jogs on a treadmill daily. He remains close to his care providers, whom he came to know during the months he waited for a heart.
“I still talk to the nurses,” he said. “They became family to us. The nurses, nurse practitioners, the doctors, anybody that was on the floor the entire day, I still go see them. I still check in with them.”
Ordway, who has been at the Medical Center since 1986, is impressed every day by what the staff does for patients.
“All of these patients are extremely special,” said Ordway. “I’ve had patients say to me, they all feel like they’re the only special ones. Isn’t that great, that every patient feels like they’re the special one? They can tell that the nurses really love their jobs. It’s all about the patient and our team is here for every patient. Keeping the patient as the focus is one of the things we do incredibly well.”
Patients are the priority
Creating a top-notch transplant program relies on the relationships the team has built with referring doctors, said Klarman. Tufts Medical Center’s specialists are accessible and easy to communicate with, and they maintain a very patient-focused approach to the care that we have, she said.
“When you refer patients to our program, we prioritize clear and consistent communication with you as a valued partner in their care. Our team is committed to collaboration, recognizing that this partnership enhances patient outcomes and ensures the highest level of care,” she said.
Dr. Udelson said Tufts Medical Center looks at referring physicians as partners and wants them to be actively involved in care rather than just saying, “Please send us the patients.”
“I think it’s really this model of the partnerships with the people in the community,” Udelson said. “That’s really the ‘secret sauce.’ The other places in town are trying to do that, but we have had a 25-year head start, it’s very unique.”
The program’s success in achieving record-breaking numbers is thanks to the decades of trust that Tufts Medical Center has built with the major care centers and doctors who refer patients to the medical center.
“I think it’s a trust that has been built over many years and we’re seeing the benefits of that,” said Dr. Rajapreyar. “And the ability of these patients to follow up with their local physician after a certain period of time has helped take the burden off these patients to not come to Boston every time.”
Keeping hearts alive
In addition to having partnerships with care centers and referring physicians, the Medical Center uses new technology that keeps hearts alive longer, allowing them to come from further away.
“One of the cornerstones of our growth has been leveraging advanced perfusion, preservation, and logistics technologies, which enable our team to travel up to 3,500 nautical miles to recover hearts,” said Klarman. “This capability not only expands access to donor hearts but also significantly shortens the time patients wait for a transplant, ensuring we can provide lifesaving care to more individuals.”
Dr. Udelson said that a few years ago, the window for a heart was only 4 hours away before it started to go bad. Previously the range for getting hearts was about 1,000 miles. Now that range has expanded, the program can even get hearts from the West Coast, which has made a big difference, he said.
Tufts Medical Center also set a national record for the longest distance a heart was transported for transplant at 2,921 nautical miles. Increased access to healthy hearts means increased transplants and lives saved. Since 2000 the Medical Center has performed the most adult heart transplants in New England (727), outpacing the next-closest center by more than 70 transplants during that time.
The record-breaking program is a testament to the entire team's dedication from beginning to end.
“I’m very fortunate to be a part of this team,” said Dr. Rajapreyar. “It is a different atmosphere where the level of commitment is just beyond what I would (imagine). People come together, no matter night or day, the patient comes first. I think everyone puts patients first. It’s just a different environment, and I feel like I would have my family members and friends treated here. It’s just a very unique place.”
