Eric Rose

Last updated

Eric A. Rose
Alma mater Columbia University (BA, MD)
Occupation Cardiothoracic surgeon
Known for
  • Performing first successful paediatric heart transplant 1984
  • Leading REMATCH Trial
Medical career
Institutions Mount Sinai Heart
Sub-specialties Cardiothoracic surgery
Research Medical devices
AwardsBakken Scientific Achievement Award

Eric A. Rose is an American cardiothoracic surgeon, scientist, entrepreneur and professor and Chairman of the Department of Population Health Science & Policy, and Associate Director for Clinical Outcomes at Mount Sinai Heart. He is best known for performing the first successful paediatric heart transplant, in 1984 while at NewYork–Presbyterian Hospital (NYP).

Contents

Later, he led the REMATCH Trial, published 2001, which compared the permanent implantation of a Left Ventricular Assist Device (LVAD) with conventional medical treatment in people with severe heart failure who were not eligible for heart transplantation.

Rose has co-founded several biotechnology companies and has been involved in developing anti-virals to smallpox, new medical technologies and new approaches to Alzheimer's disease and bioterrorism.

He was president of the International Society for Heart and Lung Transplantation for 1993–94.

Early life and family

Rose attended the Bronx High School of Science and was class of 1968. At school, he was part of a rockband called Metropolitan Blues Express, an experience he has described as "diverse" and useful as an exercise in "team-building". [1]

He married anaesthesiologist, Ellise Delphin, and they have four children who all live in Manhattan. [2] [3]

Early medical career

NewYork-Presbyterian Hospital/Columbia campus ColumbiaMedicalCenter crop.jpg
NewYork–Presbyterian Hospital/Columbia campus

Rose completed both his undergraduate, major in psychology at Columbia University, and his medical degree at Columbia University College of Physicians and Surgeons . [4] [5] [6] After graduation he did his residencies in surgery and thoracic surgery at what was then the Presbyterian Hospital. [7] [8]

He spent more than 25 years at Columbia-Presbyterian Medical Center, now NewYork–Presbyterian Hospital / Columbia University Medical Center. During his career at NYP, he held numerous positions including director of the Clinical Perfusion Service and of the Surgical Cardiac Intensive Care Unit, chief of the Cardiothoracic Surgical Service, the Morris and Rose Milstein Professor of Surgery, and associate dean for translational research. [8]

He was president of the International Society for Heart and Lung Transplantation (ISHLT) for 1993–94. [9]

Heart transplantations

Paediatric heart transplantation, 1984

Keith Reemtsma had started an adult transplantation programme in 1977 at NewYork–Presbyterian / Columbia and recruited Rose and others to initiate paediatric transplantations. The then-new immunosuppressant Cyclosporin was approved by the FDA in 1983 and contributed to the first successful heart transplant in a child in June 1984. [10]

James Lovette, from Denver, [11] was born with a single ventricle, a condition that was fatal in 1984. The longest survival in a child heart transplant procedure was eighteen days until Rose and his team performed four year old James’s heart transplant on 9 June 1984. [1] The donor heart came from Dorothy Ford's son, John Ford, who was also a four-year-old boy who died after falling from a New York apartment trying to escape a fire. [11] Magnifying glasses helped Rose visualise James's small heart during the surgery and afterwards, rejection was prevented by tailoring the dose of cyclosporine. [10] At the age of 10 years, he required a second heart transplant. [12]

James survived twenty one years after the first transplant, [1] during which at one time he also suffered from Hodgkins lymphoma. His parents were able to witness his graduation and the start of a medical career. However, during his first week of medical school, he died in his sleep. [10] [13]

Frank Torre, 1996

On 25 October 1996, Rose led the heart transplant procedure on Yankees manager Joe Torre's brother, 64-year-old baseball player Frank Torre. [14] The previous day, a 28-year-old man from The Bronx had died of severe brain injury at Montefiore Medical Center and his family had consented to donate his kidneys, liver, pancreas and heart. Computer software used by the New York Regional Transplant Programme matched blood, tissue type and dimensions of the heart of this donor with that of John's. Already having had three heart attacks and suffering from severe (class IV) congestive heart failure, John had a very poor quality of life and was severely limited in mobility. [15]

On the morning of the operation, Rose, with Mehmet Oz, MD who was his deputy in the NYP/Columbia Department of Cardiothoracic surgery at the time, took four hours to complete the procedure and by midday the surrounding publicity was immense. [15] The operation was successful and over the coming days, Frank managed to watch his brother’s baseball team beat the Atlanta Braves to win the Series. [14]

REMATCH (Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure) Trial

Background

During the 1990s, LVADs were used successfully as a bridge-to-transplantation device, that is, to fill the time before a suitable donor could be found, and medical treatment options were limited. Despite the uncertainties, the clinical potential of LVADs for transplant-ineligible heart failure patients encouraged Rose and others to expand the use of these devices beyond their short-term use. Its safety and life expectancy were unknown, and it was unclear as to whether they would provide better outcomes than conventional treatment with medication in people with severe heart failure. Cost-effectiveness was also a factor. [16] [17]

PREMATCH

The first phase, April 1996 to April 1998, was called PREMATCH and it demonstrated enough data to move to the next larger scale trial. It revealed that the severely ill, older, not fit for heart transplant person could withstand the implant procedure, the implant used being the HeartMate LVAD. However, it was still uncertain as to whether those with an LVAD performed clinically better. Thoratec Corporation demonstrated sufficient safety, efficacy and reliability data to secure premarket approval. With further modifications to the trial methods, the REMATCH protocol was finalized for the second phase multicenter RCT. [16]

Second phase

Led by Rose when he was chair of Columbia University and surgeon-in-chief at Columbia Presbyterian Medical Center, the REMATCH randomized clinical trial was conducted from May 1998 to July 2001 in collaboration between Columbia University, the National Institutes of Health (NIH) and the Thoratec Corporation. It compared the permanent implantation of a left ventricular assist device (LVAD) with conventional medical treatment in people with heart failure who were not eligible for heart transplantation. [16]

The LVADs were donated by the Thoratec Corporation and the NIH provided finances for the administration and the collection and analysis of data. The CMS and participating hospitals paid for treatment and hospitalization costs. The potential financial exploitation of vulnerable people with life-threatening disease was omitted by not having any charges for study costs and the whole trial was supervised by a steering committee and conveyed by an operations committee with an independent coordinating centre. All 129 people in the trial were not eligible for transplant surgery. They were typically older, with severe left ventricular dysfunction and other medical problems including pulmonary hypertension, peripheral vascular disease and renal disease. 68 people received a LVAD, Thoratec’s HeartMate XVE LVAD, and 61 received drug treatment. [16]

The results surprised many medical professionals. LVAD patients lived significantly longer than those on medical treatment. [16] [18] [19]

Later career and other roles

Rose co-founded several biotechnology companies including Nephros, which is concerned with heart and kidney related medical devices, and between 1997 and 2009, has served at various points, as its chairman, president, chief executive and director. Between 2007 and 2016, he was chief executive of the anti-viral developer SIGA Technologies, having been an executive director at SIGA since 2001 and a member of the National Biodefense Science Board since 2007. He was appointed executive vice president for life sciences at MacAndrews & Forbes in 2007, a position he held until 2016. [4] [5]

Rose joined Mount Sinai in 2008 [4] as the Edmond A. Guggenheim, Professor and Chairman of the Department of Population Health Science & Policy, and Associate Director for Clinical Outcomes at Mount Sinai Heart, [8] taking his 40-member team with him. [3]

He has particularly worked on anti-virals to smallpox [3] and developing medical technologies and new approaches to Alzheimer's disease and bioterrorism. [5]

He has three patents to his name, has brought more than $50 million in on-going federally financed research, and has been recognized as a "grant magnet" by Mount Sinai. [3]

Awards

Selected publications

Rose has authored and co-authored more than 300 peer-reviewed articles on subjects including cardiovascular surgery, ventricular assist devices, and cardiac transplantation. He also wrote two books: Management of End-Stage Heart Disease and Second Opinion: The Columbia Presbyterian Guide to Surgery. [8] His work has been cited in over 3,000 other articles. [1]

Books

Articles

Related Research Articles

<span class="mw-page-title-main">Cardiothoracic surgery</span> Medical specialty involved in surgical treatment of organs inside the thorax

Cardiothoracic surgery is the field of medicine involved in surgical treatment of organs inside the thoracic cavity — generally treatment of conditions of the heart, lungs, and other pleural or mediastinal structures.

<span class="mw-page-title-main">Magdi Yacoub</span> Egyptian retired professor and surgeon (born 1935)

Sir Magdi Habib Yacoub, is an Egyptian retired professor of cardiothoracic surgery at Imperial College London, best known for his early work in repairing heart valves with surgeon Donald Ross, adapting the Ross procedure, where the diseased aortic valve is replaced with the person's own pulmonary valve, devising the arterial switch operation (ASO) in transposition of the great arteries, and establishing the heart transplantation centre at Harefield Hospital in 1980 with a heart transplant for Derrick Morris, who at the time of his death was Europe's longest-surviving heart transplant recipient. Yacoub subsequently performed the UK's first combined heart and lung transplant in 1983.

<span class="mw-page-title-main">Ventricular assist device</span> Medical device to assist or replace a heart

A ventricular assist device (VAD) is an electromechanical device for assisting cardiac circulation, which is used either to partially or to completely replace the function of a failing heart. The function of a VAD differs from that of an artificial cardiac pacemaker in that a VAD pumps blood, whereas a pacemaker delivers electrical impulses to the heart muscle. Some VADs are for short-term use, typically for patients recovering from myocardial infarction (heart attack) and for patients recovering from cardiac surgery; some are for long-term use (months to years to perpetuity), typically for patients with advanced heart failure.

<span class="mw-page-title-main">O. H. Frazier</span> American physician

O. H. "Bud" Frazier is a heart surgeon and director of cardiovascular surgery research at the Texas Heart Institute (THI), best known for his work in mechanical circulatory support (MCS) of failing hearts using left ventricular assist devices (LVAD) and total artificial hearts (TAH).

Sean Patrick Pinney is an American cardiologist and the Director of both the Advanced Heart Failure and Cardiac Transplant Program and the Pulmonary Hypertension Program at Mount Sinai Medical Center in New York City.

Peer Michael Portner was a heart researcher whose work led to the development of the ventricular assist device, an electrical pump that permits patients in heart failure to survive until a heart transplant could be performed.

<span class="mw-page-title-main">Robert E. Michler</span>

Robert E. Michler is an American heart surgeon specializing in heart surgery, aortic and mitral valve repair, coronary artery bypass surgery, aneurysm surgery, and management of the failing heart. In 2017, Michler received the Vladimir Borakovsky Prize in Moscow from the Ministry of Health of the Russian Federation for “his personal contributions to the development of cardiovascular surgery”.

Destination therapy is a therapy that is final rather than being a transitional stage until another therapy—thus, in transportation metaphor, a destination in itself rather than merely a bridge or road to the destination. The term usually refers to ventricular assist devices or mechanical circulatory support to keep the existing heart going, not just until a heart transplant can occur, but for the rest of the patient's life expectancy. It is thus a course of treatment for severe heart failure patients who are not likely candidates for transplant. In contrast, bridge-to-transplant therapy is a way to stay alive long enough, and stay healthy enough, to await transplant while maintaining eligibility for transplant.

Thoratec Corporation is a United States-based company that develops, manufactures, and markets proprietary medical devices used for mechanical circulatory support for the treatment of heart-failure patients worldwide. It is a global leader in mechanical circulatory support devices, particularly in ventricular assist devices (VADs).

<span class="mw-page-title-main">Heart transplantation</span> Surgical transplant procedure

A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease when other medical or surgical treatments have failed. As of 2018, the most common procedure is to take a functioning heart, with or without both lungs, from a recently deceased organ donor and implant it into the patient. The patient's own heart is either removed and replaced with the donor heart or, much less commonly, the recipient's diseased heart is left in place to support the donor heart.

Charles D Fraser, Jr. is the medical director and surgeon of the Texas Center for Pediatric and Congenital Heart Disease at Dell Children's Medical Center. Formerly, Fraser was chief of congenital heart surgery and cardiac surgeon-in-charge at Texas Children's Hospital, the nation's largest pediatric hospital, served as chief of the Congenital Heart Surgery Division at Baylor College of Medicine, and director of the Adult Congenital Heart Surgery Program at the Texas Heart Institute.

William F. Bernhard was an American cardiovascular surgeon, Emeritus Professor of Surgery at Harvard Medical School, and cardiovascular surgical pioneer.

James K. Kirklin is an American cardiac surgeon who has made significant scientific and surgical contributions in the fields of heart transplantation and mechanical circulatory support devices to assist the pumping action of the heart. He was formerly Professor of Surgery (1987-2022), Director of the Division of Cardiothoracic Surgery (2006-2016), Director of the James and John Kirklin Institute for Research in Surgical Outcomes (KIRSO) (2016–2022), and Co-Director of Comprehensive Cardiovascular Center (2011-2017) at the University of Alabama at Birmingham (UAB). While at UAB, he held the UAB Cardiovascular Research Chair (1998-2006), the John Kirklin Chair of Cardiovascular Surgery (2006-2017), and the James Kirklin Chair of Cardiothoracic Surgery (2017-2022).

Sharon Ann Hunt is a cardiology professor and Director of the Post Heart Transplant Programme in Palo Alto, California and is affiliated with Stanford University Medical Center, professionally known for her work in the care of patients after heart transplantation.

<span class="mw-page-title-main">Robert C. Robbins</span> American cardiothoracic surgeon

Robert Clayton Robbins, known professionally as Robert C. Robbins or R.C. Robbins, is an American cardiothoracic surgeon and the 22nd and current president of The University of Arizona. In the spring of 2023, the Faculty Senate at the University of Arizona gave R.C. Robbins a vote of “no confidence” due, in part, to the university leadership’s inaction regarding a violent student who would go on to fatally shoot a professor in October of 2022. He received a pay raise in October of 2023 from the Arizona Board of Regents. Previously, he was the president and CEO of the Texas Medical Center in Houston, Texas, from 2012 to 2017. As an internationally recognized cardiac surgeon, he has focused his clinical efforts on acquired cardiac diseases, including surgical treatment of congestive heart failure and cardiothoracic transplantation. He also serves on the board of the Greater Phoenix Economic Council.

<span class="mw-page-title-main">P. K. Sen (surgeon)</span>

Prafulla Kumar Sen MD was an Indian vascular and cardiothoracic surgeon, who led the first human heart transplant procedure in India in 1968 and became the fourth surgeon in the world to carry out this operation. It was also the sixth attempt at this procedure in the world.

<span class="mw-page-title-main">International Society for Heart and Lung Transplantation</span>

The International Society for Heart and Lung Transplantation (ISHLT), established in 1981, is a professional organization committed to research and education in heart and lung disease and transplantation. It holds annual scientific meetings and publishes The Journal of Heart and Lung Transplantation. It also holds the worlds largest registry of heart and lung transplant data.

Jack Greene Copeland is an American cardiothoracic surgeon, who has established procedures in heart transplantation including repeat heart transplantation, the implantation of total artificial hearts (TAH) to bridge the time to heart transplant, innovations in left ventricular assist devices (LVAD) and the technique of "piggybacking" a second heart in a person, while leaving them the original.

<span class="mw-page-title-main">Keith Reemtsma</span> American surgeon

Keith Reemtsma was an American transplant surgeon, best known for the cross-species kidney transplantation operation from chimpanzee to human in 1964. With only the early immunosuppressants and no long-term dialysis, the female recipient survived nine months, long enough to return to work.

Alexander R. Mărmureanu is a Romanian-born American academic.

References

  1. 1 2 3 4 5 Snyder, James (30 May 2018), Eric Rose '68 , retrieved 24 July 2018
  2. ↑ Rose, Eric (29 April 1994). "ABOUT COLUMBIA: DR. ERIC ROSE: MY TOP TEN APPRECIATIONS". Columbia University Record. 19.
  3. 1 2 3 4 Scott, Gale (26 October 2008). "Surgeon's move a coup for Mt. Sinai med school". Crain's New York Business. Retrieved 25 July 2018.
  4. 1 2 3 (us), Institute of Medicine (2012). Participant Biographies. National Academies Press (US). ISBN   978-0-309-21929-7.
  5. 1 2 3 "List of Public Companies Worldwide, Letter – Bloomberg". www.investing.businessweek.wallst.com. Retrieved 27 July 2018.
  6. ↑ "Dean's Circle Luncheon". Columbia College Today. September 2002. Retrieved 25 July 2001.
  7. ↑ "Dr Eric Rose". Health, US News. Retrieved 25 July 2018.
  8. 1 2 3 4 "Eric Rose | Mount Sinai – New York". Mount Sinai Health System. Retrieved 16 July 2018.
  9. ↑ "ISHLT: The International Society for Heart & Lung Transplantation – Past Presidents". www.ishlt.org. Retrieved 29 June 2018.
  10. 1 2 3 "History of Medicine: First Pediatric Heart Transplant | Columbia University Department of Surgery". columbiasurgery.org. Retrieved 20 July 2018.
  11. 1 2 "Donated Son's Heart". Jet. 66 (16): 18. 25 June 1984. ISSN   0021-5996.
  12. ↑ "50 years of heart transplant – timeline". www.bhf.org.uk. British Heart Foundation. Retrieved 24 July 2018.
  13. ↑ Doty, John R.; Yuh, David Daiho; Vricella, Luca A.; Yang, Stephen (2014). Johns Hopkins Textbook of Cardiothoracic Surgery, Second Edition. McGraw Hill Professional. p. 1364. ISBN   978-0-07-171493-8.
  14. 1 2 "The Operator". The New Yorker. Retrieved 25 July 2018.
  15. 1 2 Sherman, Joel (2006). Birth of a Dynasty: Behind the Pinstripes with the 1996 Yankees . Holtzbrinck Publishers. pp.  296–298. ISBN   978-1-59486-244-1.
  16. 1 2 3 4 5 McKellar, Shelley (2017). "Disruptive Potential: The "Landmark" REMATCH Trial, Left Ventricular Assist Device (LVAD) Technology, and the Surgical Treatment of Heart Failure in the United States". In Schlich, Thomas; Crenner, Christopher (eds.). Technological Change in Modern Surgery: Historical Perspectives on Innovation. University of Rochester Press. pp. 129–138. ISBN   978-1-58046-594-6.
  17. ↑ Morris, Charles R. (2007). The Surgeons: Life and Death in a Top Heart Center . W. W. Norton. pp.  79–80. ISBN   978-0-393-33423-4.
  18. ↑ "Columbia Magazine". www.columbia.edu. Retrieved 16 July 2018.
  19. ↑ Deng, Mario C.; Naka, Yoshifumi (2007). "6.Research Strategies". Mechanical Circulatory Support Therapy in Advanced Heart Failure. Imperial College Press. p. 246. ISBN   978-1-86094-728-5.
  20. ↑ "Bakken Scientific Achievement Award" (PDF). The Society of Thoracic Surgeons News. 24 January 2017.
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