Sharon Ann Hunt

Last updated
Sharon Ann Hunt
Professor
NationalityAmerican
Education Stanford University
Medical career
Profession Cardiologist
Field Heart transplant
Research Organ rejection
Awards
  • 2012, ISHLT Lifetime achievement award
  • 2013, Hewlett award

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.

Contents

With a career at Stanford spanning over fifty years, Hunt has witnessed the history of heart transplant surgery from the very first one in the US by Norman Shumway in 1968, through the international moratorium on heart transplants and the recent decades of combined heart-lung transplants and mechanical assist devices.

She is a past president of the International Society for Heart and Lung Transplantation and received their lifetime achievement award in 2012.

As one of the 130 cardiology specialists at Stanford, her other activities include contributions to Uptodate and Hurst's Cardiology and more than 200 publications.

Early life and education

Sharon Ann Hunt was brought up in Cleveland, Ohio, and completed her early education from the undergraduate school at the University of Dayton. She spent her summer breaks in a research laboratory at the Cleveland Clinic, sparking her interest in cardiology and subsequent entry to the study of medicine. [1]

Hunt began her medical career as one of seven female students in her class at Stanford in 1967, the year prior to the landmark heart transplant procedure by Norman Shumway. [2]

As a medical student, Hunt became involved in research observing the effects of several drugs on heart muscle cells in tissue culture, a project that introduced her to many of the cardiac trainees at Stanford at that time. [1]

Medical career

Hunt received a medical degree in 1972, completed a residency in internal medicine in 1974, and finished a cardiology fellowship in 1977, all at Stanford University. She achieved internal medicine certification by the American Board of Internal Medicine in 1977 and their cardiovascular disease certification in 1979. [3]

She was mentored by heart transplant pioneer Norman Shumway and pathologist Margaret Billingham and also worked with cardiothoracic surgeon Philip Caves and Edward Stinson, and has therefore witnessed the history of heart transplant surgery in the US from its early years. [2] [4]

First heart transplant, 1968

As a second-year medical student, she has recounted the first heart transplant procedure in the US as "groundbreaking...very exciting" when "the whole place was abuzz with the news of it". [5] She recalls the poor survival rates and the vast public interest which led members of the press to climb the outside of the hospital to try to get pictures inside the hospital. [5]

Organ rejection

During the late 1970s, as Hunt was completing her training, the one-year survival rates for heart transplant surgery was around 60%. Post-operative care of heart transplant patients, with long-term immunosuppression, was a new and evolving field with as yet unknown complications and problems. Over the previous decade, surgical techniques, including endomyocardial biopsy use for early transplant rejection, were improved at Stanford, under Norman Shumway. [2] The care of people who had survived the initial stages of heart transplant surgery became the focus of Hunt's research and work. Continuing the work in the recognising of and the treating of rejection, she also looked at methods in lessening drug side effects. [2] [3]

She later recalled;

When patients started living longer, the surgeons felt they needed real doctors to take care of them because they would come in for follow up with all sorts of medical complications of long-term immunosuppression. [2]

Continuing the process, which started in 1973, of monitoring acute rejection after heart transplants by taking biopsies of the heart using a bioptome and then examining the samples under the microscope, has in her professional view been one of the most significant contributions to detecting rejection. [6]

Hunt is known by a number of her colleagues as the "mother of transplant", [4] having been involved in major transplant guidelines including the "2009 Guidelines for the Diagnosis and Management of Heart Failure in Adults”. [4]

In her paper on mechanical circulatory support in 2007, she stated that the grading of “transplant ineligible” at one moment in time is not automatically a permanent decision. [7]

In 2013, Hunt described one-year survival rates of 90% with many living for over thirty years. [2]

Mechanical assist devices

Hunt was involved in the care of Robert St. Laurent, the case of the world's first successful implantation of an LVAD, as a bridge to transplantation, in 1984. [4] [8] The device used was the “Novacor” (left ventricular assist system), which used an electromechanically driven dual pusher-plate blood pump. Later, the Thoratec HeartMate XVE device became approved with the landmark REMATCH trial. [9]

Hunt wrote the commentary on the REMATCH trial, "Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure", a trial led by Eric A. Rose. [10] This trial intended to assess the suitability of using a LVAD in the long-term in people with end-stage (severe) heart failure who were not suitable for heart transplantation. Just under 130 people with at least three months of (class IV) congestive heart failure, despite maximum tolerated treatment with drugs and who were ineligible for heart transplantation, were recruited and assigned to either fitting with an LVAD or treatment with medicines only, and all co-ordinated by a specialist co-ordination centre. Despite frequent complications of infection, thrombosis, cerebrovascular disease, device malfunction and one left ventricular dysfunction in the LVAD group, they [LVAD group] had a significantly improved survival rate to those that received medication only and where deaths were due to mostly left ventricular dysfunction. Scores on quality of life depended on the questionnaires used. [11] [12]

Although using LVADs as an artificial heart in order to buy time and bridge the gap until a heart transplant was initially for short-term means, some people have kept them for long periods of time and some have been able to wean off the device to recovery. [11]

During that presentation at the American Heart Association 2002 annual meeting, Hunt made it clear that she believed that the REMATCH trial symbolised a basis "for all future trials of mechanical heart replacement.” [10]

Appointments

Her career subsequently evolved at Stanford and she progressed as clinical instructor and assistant, associate professor and then eventually clinical professor in 1993, becoming professor in the Division of Cardiovascular Medicine. [2]

She is one of the 130 cardiology specialists at Stanford. [13] In 2010 she became board certified in advanced heart failure and transplant cardiology. Heart transplants are a focus of her practice. [3]

Organisations

Hunt succeeded John Wallwork in 1995 to serve as president of the International Society for Heart & Lung Transplantation from 1995 to 1996. [14] [15] She was succeeded by William Baumgartner. [14]

She is a Master of the American College of Cardiology. [16]

She works with UpToDate and Hurst's The Heart. [1]

Awards and achievements

On 19 April 2012, at the ISHLT 32nd Annual Meeting and Scientific Sessions in Prague, Czech Republic., [15] she was awarded the ISHLT Lifetime achievement award, [2] the fifth recipient of that award. [17] A year later, she received the Hewlett award. [2]

She has published more than 200 peer-reviewed articles. [2] In 2014, the Institute for Scientific Information included Hunt in its ISI Highly Cited database, which lists scientists whose publications have been most often cited by other researchers. [18]

She has chaired joint committees of the American College of Cardiology and American Heart Association which have revised patient care guidelines for heart failure. [19]

Personal and family

Hunt married a psychologist. He died in 2004. [1] She has one daughter who is a police officer in Sacramento. [2]

Close to home, some of her time is spent with horses, growing orchids and traveling. “One of the privileges of what I’ve done over the years is the opportunity to travel all over the world as an honoured guest”. [2]

Selected publications

Books

Papers

Guidelines

Related Research Articles

<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 that provides support for cardiac pump function, which is used either to partially or to completely replace the function of a failing heart. VADs can be used in patients with acute or chronic heart failure, which can occur due to coronary artery disease, atrial fibrillation, valvular disease, and other conditions.

Bruce A. Reitz is an American cardiothoracic surgeon, best known for leading the first combined heart-lung transplantation in 1981 with pioneer heart transplant surgeon Norman Shumway. He obtained an undergraduate degree at Stanford University a medical degree at Yale Medical School and completed an internship at Johns Hopkins Hospital (1971) and residencies and fellowships at Stanford University Hospital the National Institutes of Health (1974). He joined the surgical faculty at Stanford University (1978) then became chief of cardiac surgery at Johns Hopkins University (1982–92) and Chairman of the Department of Cardiothoracic Surgery at Stanford (1992–2005). In 1995 he conducted another pioneering operation: the first Heartport procedure, using a device that allows minimally invasive coronary bypass and valve operations. Reitz also played a major role in the resident education program at Stanford, which he reorganized and maintained.

<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).

Management of heart failure requires a multimodal approach. It involves a combination of lifestyle modifications, medications, and possibly the use of devices or 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.

Mandeep R. Mehra is The William Harvey Distinguished Chair in Advanced Cardiovascular Medicine and a professor of medicine at Harvard Medical School. He is the medical director of the Brigham Heart and Vascular Center in Boston, Massachusetts, and specializes in advanced heart failure, mechanical circulatory support and cardiac transplantation.

<span class="mw-page-title-main">Ischemic cardiomyopathy</span> Medical condition

Ischemic cardiomyopathy is a type of cardiomyopathy caused by a narrowing of the coronary arteries which supply blood to the heart. Typically, patients with ischemic cardiomyopathy have a history of acute myocardial infarction, however, it may occur in patients with coronary artery disease, but without a past history of acute myocardial infarction. This cardiomyopathy is one of the leading causes of sudden cardiac death. The adjective ischemic means characteristic of, or accompanied by, ischemia — local anemia due to mechanical obstruction of the blood supply.

Pump thrombosis (PT) is considered a specific case of a major device malfunction, and is classified as either suspected or confirmed pump thrombus. Typically, the device is an implanted blood pump such as a left ventricular assist device. The malfunction is a blockage in the flow of blood anywhere along a vessel and it is mainly due to the bio-incompatible presence of a fairly complex mechanical apparatus. Pump thrombus is dreaded complication of CF LVAD technology that can require repeat surgery to replace the pump or lead to death.

Philip Caves (1940–1978) was a Northern Irish cardiothoracic surgeon. In 1972, while at Stanford University, he pioneered the use of the bioptome and transvenous endomyocardial biopsy in the early diagnosis of heart transplant rejection. It was considered the most significant advance in antirejection therapy of the time. Awarded the British American Research Fellowship in 1971, Caves worked with pioneering cardiothoracic surgeon Norman Shumway at Stanford and became staff surgeon leading the transplant programme by 1973. A year later he went to Edinburgh as a senior lecturer in cardiac surgery, where he became particularly interested in pediatric cardiac surgery.

<span class="mw-page-title-main">Margaret Billingham</span> Kenyan-born American pathologist (1930-2009)

Margaret E. Billingham was a pathologist at Stanford University Medical Center, who made significant achievements in the early recognition and grading of transplant rejection following cardiac transplantation, known as 'Billingham's Criteria'. She also described chronic rejection and techniques in heart endomyocardial biopsy.

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

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.

<span class="mw-page-title-main">Stuart W. Jamieson</span> British surgeon

Stuart William Jamieson is a British cardiothoracic surgeon, specialising in pulmonary thromboendarterectomy (PTE), a surgical procedure performed to remove organized clotted blood (thrombus) from pulmonary arteries in people with chronic thromboembolic pulmonary hypertension (CTEPH).

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.

Edward B. Stinson is an American retired cardiothoracic surgeon living in Los Altos, United States, who assisted Norman Shumway in America's first adult human-to-human heart transplantation on 6 January 1968 at Stanford University.

<span class="mw-page-title-main">Michael L. Hess</span>

Michael L. Hess was an American professor of cardiology and physiology at the Medical College of Virginia (MCV) who was instrumental in founding the International Society for Heart and Lung Transplantation (ISHLT), of which he served as its first president.

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).

<span class="mw-page-title-main">Cardiac allograft vasculopathy</span> Medical condition

Cardiac allograft vasculopathy (CAV) is a progressive type of coronary artery disease in people who have had a heart transplant. As the donor heart has lost its nerve supply there is typically no chest pain, and CAV is usually detected on routine testing. It may present with symptoms such as tiredness and breathlessness.

Mario Chih-Hsiung Karl Deng is a German-Chinese cardiologist specialized in the care of patients with advanced heart failure. Deng is a Professor of Medicine in the David Geffen School of Medicine at the University of California, Los Angeles.

References

  1. 1 2 3 4 "Sharon Hunt". PracticeUpdate. Retrieved 3 September 2018.
  2. 1 2 3 4 5 6 7 8 9 10 11 12 "Cardiologist Sharon Hunt to Receive Hewlett Award". Department of Medicine
    News    . Retrieved 1 September 2018.
  3. 1 2 3 "Sharon Hunt, M.D." Stanford University Medical Center.
  4. 1 2 3 4 Ross, Heather (November 2011). "Video interview with Sharon Ann Hunt". ww.ishlt.org. Retrieved 2 September 2018.
  5. 1 2 "Stanford marks 50 years since first U.S. adult heart transplant performed there". ABC7 San Francisco. 5 January 2018. Retrieved 3 September 2018.
  6. ↑ "Marking 50 Years Since The First Adult Heart Transplant In The U.S." NPR.org. Retrieved 3 September 2018.
  7. ↑ McKellar, Shelley (2017), p.153
  8. ↑ "Heart transplant reunion party celebrates lifesaving milestone". news.stanford.edu. Retrieved 4 September 2018.
  9. ↑ Nosé, Yukhiko; Motomra, Tadashi (2011). "History of mechanical Circulatory Support". In Joyce, David L.; Joyce, Lyle D.; Locke, Matthias (eds.). Mechanical Circulatory Support: Principles and Applications. McGraw Hill Professional. p. 3. ISBN   978-0-07-178507-5.
  10. 1 2 "Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure - American College of Cardiology". American College of Cardiology. Retrieved 5 September 2018.
  11. 1 2 Hunt, Sharon A. (April 2002). "Comment--the REMATCH trial: Long-term use of a left ventricular assist device for end-stage heart failure". Journal of Cardiac Failure. 8 (2): 59–60. doi:10.1054/jcaf.2002.32944. ISSN   1071-9164. PMID   12016626.
  12. ↑ 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.
  13. ↑ "Dr Sharon Hunt, Cardiology Profile" . Retrieved 3 September 2018.
  14. 1 2 "ISHLT Past Presidents". The International Society for Heart & Lung Transplantation. Retrieved April 4, 2015.
  15. 1 2 "ISHLT: The International Society for Heart & Lung Transplantation - 2012 Lifetime Achievement Award Recipient". www.ishlt.org. Retrieved 4 September 2018.
  16. ↑ "2014 Distinguished Awardees". American College of Cardiology. Archived from the original on April 10, 2015. Retrieved April 4, 2015.
  17. ↑ "Lifetime Achievement Award". International Society for Heart & Lung Transplantation. Retrieved April 4, 2015.
  18. ↑ "Highly Cited Researchers". Institute for Scientific Information . Retrieved April 4, 2015.
  19. ↑ Hunt SA, Abraham WT, Chin MH, et al. (2005). "ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult". Circulation . 112 (12): e154–e235. doi: 10.1161/CIRCULATIONAHA.105.167586 . PMID   16160202.
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