“Everyone has been great and has helped me get my life back. The doctors and nursing staff all really care. You can tell this is much more than just a job for them."
Dashawn Womack is thankful to be alive. Diagnosed with nonischemic dilated cardiomyopathy, the Trenton resident’s heart was failing. The condition left Womack’s heart unable to pump blood properly throughout his body restricting the 34-year-old’s ability to perform day-to-day activities or even to walk short distances without becoming profoundly short of breath.
In January, as his condition impacted his liver and kidney functioning, he was transferred to Robert Wood Johnson University Hospital (RWJUH) in New Brunswick. He was evaluated and placed on the heart transplant list and treated by a multidisciplinary team lead by Deepa Iyer, MD, Heart Transplant Program Director specializing in Advanced Heart Failure & Transplant Cardiology, Hirohisa Ikegami, MD, Surgical Director of Heart Transplant and Mark Russo, MD, MS, Chief of the Division of Cardiac Surgery and member of RWJBarnabas Health Medical Group.
In early March, Womack’s condition became more critical. He suffered from repeat episodes of life-threatening cardiac arrhythmias. In order to avert a sudden cardiac death, the team at RWJUH lead by Dr. Ikegami placed Womack on two life support devices, extracorporeal membrane oxygenation (ECMO) and Impella device. These two devices together served to functionally replace his heart as well as his lungs, with the hope that a donor heart would become available for him to undergo a heart transplantation.
“ECMO is the most aggressive form of temporary life support available. It works by drawing blood out of the body, oxygenating it and then returns it to the body,” said Dr. Iyer. “ECMO is not meant to be a long-term solution but remarkably, Dashawn was on the ECMO machine for almost four weeks as we waited for a suitable donor heart.”
As they waited, Womack’s care team focused not only on stabilizing him from a cardiovascular standpoint for a transplant surgery, but also combating additional challenges presented by the COVID-19 pandemic.
“I have been involved in hundreds of transplants, and in my experience, this case stands out for so many reasons,” Dr Russo said. “First, I can’t remember a patient who survived as long on ECMO support while awaiting heart transplant. We know that the longer a patient is supported by ECMO, the higher the risk for complications, including stroke and severe infection.
"Also, we needed to protect against previously unseen risks, including infection with COVID-19 which would have severely impacted his already fragile condition and precluded us from safely transplanting Dashawn. Finally, for a variety of reasons related to the new realities created by this pandemic, already scarce donor organs have become even more critically scarce for people like Dashawn awaiting transplant. ”
On April 6, more than two months after he entered the hospital and nearly a month after he has placed on ECMO, Womack got the good news from Dr. Iyer that there was a suitable heart for him. “I was so happy,” recalled Womack. “I didn’t really have any fear. My mom passed away from the same disease so I knew if didn’t get the transplant I wouldn’t be here anymore. I knew it was something I needed to do.”
Dr. Ikegami had procured a heart for him from a hospital out of state, a process further complicated by COVID-19. UNOS, the national body that oversees transplantation in the United States had issued an order that organs procured for transplant should be done by local teams. Despite the challenges, Dr. Ikegami was able to safely transport the organ to RWJUH and Womack was prepped for surgery.
That night, Womack received his new heart. “The transplant could not have gone more smoothly,” said Dr. Russo. “As a result of thoughtful planning, the cardiac support devices that Dashawn required were placed percutaneously; that is without the need to enter the chest and thus avoiding additional trauma to his heart. That dramatically simplified the removal of his native heart and the implantation of the donor heart. Likely, the more challenging part was coordinating with the team to safely remove him off the ECMO and Impella devices which had supported him for nearly a month.”
Just five days after his heart transplant Womack was up and walking in the hospital and after just nine days following surgery, Womack went home.
“It’s really a miracle,” said Dr. Iyer. “There were so many factors that made this case very complex. Prior to his surgery he was immobile since he was on the ECMO, so to see him up and walking just five days after his transplant was a really special moment for our entire team and just incredible.”
For Womack, his care team at RWJUH has become a second family. With strict visitor restrictions in place due to COVID-19, he relied on their support, compassion and friendship during his hospital stay. His team helped keep his spirits up and arranged for FaceTime conversations with his family.
“It’s all about the people that surround you. Everyone has been great and has helped me get my life back. The doctors and nursing staff all really care. You can tell this is much more than just a job for them,” said Womack. “They have all become my second family. I’m really grateful.”
Dr. Iyer feels the same about Womack. He’ll continue to be treated by her team indefinitely. “He’s part of our family now.”
In addition to Drs. Iyer, Ikegami, and Russo, Womack’s care team included Dr. Dulnuan and Dr. Moin who also specialize in Advanced Heart Failure, Transplant Cardiology, and Cardiac Anesthesiology, specially trained and certified nurse practitioners, cardiac perfusionists, critical care specialists, registered nurses, registered dietitian, pharmacists, social worker, cardiac rehabilitation therapists and other medical professionals dedicated to heart care.
“It truly takes a village to care for critically ill patients like Dashawn,” said Dr. Iyer. “Doing so during a pandemic adds to the complexities but we have the right systems in place and the caregivers at RWJUH to ensure we can provide the highest level of care for Dashawn giving him the best chance at being able to live a long healthy life. To go home just nine days post-transplant is absolutely remarkable.”
Womack is recovering at home where he is practicing strict social distancing measures to avoid any complications post-transplant. “I’m really happy to be home and I’m looking forward to hopefully being able to return to work once I’m recovered and coronavirus is no longer a threat. I’m feeling really good and I’m lucky to have a strong support system.”
“Dashawn’s case is likely one that not one of us will ever forget,” said Dr. Russo. “At a time in our history marked by fear and untimely death, Dashawn demonstrated remarkable courage, persistence, and a will to live. He has been an inspiration to all of us at a moment when it has been greatly needed.”