Deborah Trefts
Staff writer
Everyone growing up in the United States — no matter their ethnicity or gender — has at least a 50/50 chance of suffering from a cardiovascular disease. CVDs include (in order of prevalence) coronary heart disease, stroke, high blood pressure, congestive heart failure and diseases of the arteries. For non-Hispanic Black Americans, there’s a 59% chance of having some form of CVD.
According to the American Heart Association, nearly every 40 seconds, somebody in the United States is having a heart attack. Within one of their heart’s coronary arteries, the flow of blood has lessened or stopped.
When medical and surgical treatments aren’t successful and a patient has been diagnosed with end-stage heart failure, a cardiac transplant procedure is the only option remaining. Annually, over half of the world’s heart transplants are performed within the United States, yet the aggregate waiting list for life-extending donor hearts numbers in the thousands. Moreover, many end-stage cardiac patients also need a lung transplant.
Given the human lives lost, and the anguish felt by waitlisted patients, their loved ones and the medical experts who spend their days and nights treating and caring for adults and children on death’s door, discovering viable means of substantially increasing the availability of functioning donor hearts and lungs is imperative.
This has long been Dr. Bartley Griffith’s top priority. At 3 p.m. Saturday in the Hall of Philosophy — as part of the Chautauqua Women’s Club’s Contemporary Issues Forum — he will answer the question, “Why a Pig Heart?”
Griffith is director of the Cardiac and Lung Transplant Programs, vice chair for Innovation, and the Thomas E. and Alice Marie Hales Distinguished Professor of Transplant Surgery at the University of Maryland Medical Center in Baltimore. He is also a Chautauquan.
A fellow of both the American College of Surgeons and the Royal Colleges of Surgeons (Edinburgh, Scotland), he has described himself as “an everyday heart surgeon … whose clinical and investigational work has focused on the treatment of end-stage heart and lung disease.”
Over the years, Griffith has authored or co-authored hundreds of peer-reviewed articles, a book and more than 80 book chapters, and he is currently writing a book focusing on the heart.
An excerpt of a chapter, “How Do You Ask a Dying Man to Accept a Pig’s Heart?” has been published on the Substack “Narratively.”
Heart disease “is the No. 1 cause of death,” Griffith said. “You don’t see people dying from heart attacks as much (now), but from heart failure, which affects 1 million new patients a year in the U.S. Half of them die from it. Watching people die is a terrible thing, particularly children.”
During the 1940s, one of his grandfathers was the chief of surgery at the University of Pittsburgh. Because this grandfather died when he was in his 50s, Griffith never met him. But many times when Griffith was having Sunday dinner at the Pittsburgh Athletic Association with his grandmother, “people would come up to her and say how much (her husband) meant to them.”
Having grown up as a healthy kid who “always wanted to be a doctor,” Griffith entered Bucknell University in Lewisburg, Pennsylvania, in 1966. He returned to Pittsburgh during vacations and, as “jobs were hard to come by,” earned money as a taxicab driver doing short, local runs within Squirrel Hill with repeat customers who appreciated his willingness to carry their groceries upstairs.
“On a big day, the meter was $30,” he said. “Forty percent went to the taxicab company.”
In Pittsburgh, Griffith was introduced to innovations in cardiac surgery at a young age.
“By the time I was in college, my future wife’s parents began to expose me to Pittsburgh’s leading heart surgeon, George Magovern,” Griffith said. “Dr. Magovern was this wonderful guy, and he was creative and the head of the largest surgery department in Pittsburgh. (When) I got a call … that he had done a heart transplant, … I was over the moon. The more I was interested in him, the more he was in me.”
Magovern, a pioneering physician, had joined Allegheny General Hospital’s medical staff in 1959. In 1962, he implanted the Magovern-Cromie Heart Valve (the first sutureless heart valve in the United States), and in 1963, he performed the world’s second lung transplant. He began performing coronary artery bypass surgery with cardiologist Frank Begg during the early 1970s, and in the late 1970s, he developed the region’s first trauma center. Magovern served as the chair of Allegheny’s department of surgery from 1979 to 1994.
Back at Bucknell, Griffith convinced his adviser (a professor known as “the hamster lady”) to let him learn how to perform heart transplants in rats in a lab, which he then made into an operating room. The rats he was given were “discard breeders” from the psychology department — “they were older and had been through the mill as far as testing.”
Griffith said he gave each rat chloral hydrate (aka “a Mickey Finn”) to “knock it out.” Then he removed the donor’s heart, placed it in cool salt water, slit the recipient’s abdomen and inserted the donor heart.
“I became known as the ‘rodent anesthesiologist,’ as well as a rodent surgeon,” he said. “These rats were angry. … It was a big deal; I was a mini hero.”
Not long after a heart recipient “woke up, sat up and ran off the table (while) its tummy was still open,” then fled the lab, escaping into Taylor Hall as Griffith chased but could not catch it, he “died 1,000 deaths,” and his transplant procedures ended.
“A lot of my life is testing then doing,” he said. “If you can’t test, you can’t do.”
After graduating from Bucknell with a Bachelor of Science in 1970, Griffith went to Jefferson Medical College (now Sidney Kimmel Medical College) at Thomas Jefferson University in Philadelphia, which he said was known in Pittsburgh for its surgery program.
At TJU Hospital in May 1953, John Gibbon and Frank Allbritten Jr., had performed the first successful open heart procedure on a human being. They used the heart-lung machine that Gibbon had been developing for years at Harvard University and the University of Pennsylvania. He retired as chief of surgery just three years before Griffith matriculated.
“When I graduated from medical school, I had a family,” Griffith said. “It seemed right to go to the University of Pittsburgh (School of Medicine).”
At Pitt, he undertook his surgery internship, general and cardiothoracic surgery residency and a research fellowship, and from 1979 to 1981 served as chief resident for cardiothoracic surgery.
In 1979, when he was 30, Griffith performed his first open heart surgery.
“Upon completion of my residency training, I inherited the embryonic cardiac transplantation program at the University of Pittsburgh,” Griffith wrote in his curriculum vitae. “Soon I advanced the field with studies of novel immunosuppressants (cyclosporine and tacrolimus). The program built a reputation for treating the most morbidly ill transplant candidates. Due to inadequate donor hearts, I began exploring the use of mechanical substitutes and was an early user of the Jarvik Total Artificial Heart.”
He continued, “… Soon (our team of surgeons and engineers was) exploring ventricular assist devices through their development in the laboratory and in the clinic. I was among the original surgical team to implant the world’s first HeartMate II small format axial flow pump in a human after its development in part in our laboratory.” This pump “became the market leader.”
Over the years, Griffith was promoted from assistant to associate to full professor of surgery at Pitt, and in 1990, he was named the Henry T. Bahnson Professor of Surgery.
In 1963, “Hank Bahnson … took the chairmanship at Pitt,” Griffith said. “He was bigger than life — spellbinding. He recruited Thomas Starzl, who set the stage for Baltimore. … When (he) landed, there was incredible energy.”
Starzl brought cyclosporine with him when he left the University of Colorado for Pitt in late December 1980. According to Griffith in his CV, “(O)ur center became only the second in the United States to have the opportunity to test (this) immunosuppressant in heart and lungs.”
“During that time, I fell under Dr. Starzl’s spell, literally, because I saw him dealing with hearts that were broken,” Griffith said. “… I was doing more transplants than bypasses because Dr. Starzl gave me better (antirejection) drugs.”
Bahnson and Starzl became his mentors, just as Magovern had been when Griffith was in college. He said that people who were leading heart programs all over the United States visited Pitt’s program.
“It was hard, hard work with 120-hour work weeks,” Griffith said. His grandparents had a home in Bemus Point, and when his family visited, “more often than not, I had to leave early.”
For decades, Griffith approached “the clinical burden of insufficient donor organs … by bioengineering developments in the total artificial heart, ventricular assist devices, extracorporeal membrane oxygenation (ECMO) and ambulatory ECMO.”
To do so, he raised $10 million from philanthropic donors for what would become the free-standing, multi-use McGowan Center for Artificial Organ Development at the University of Pittsburgh.
In 2001, Griffith moved to Baltimore to become professor of surgery and chief of cardiac surgery at the University of Maryland Medical Center. He was named UMMC’s Thomas E. and Alice Marie Hales Distinguished Professor in 2008.
He quickly established an affiliation with the bioengineering graduate faculty of the University of Maryland, College Park, and in 2007 began serving as an adjunct professor of bioengineering.
At UMMC, Griffith joined Muhammad Mohiuddin’s Xenoheart laboratory in 2018. Together, he and Mohiuddin performed the first successful heart transplant from a genetically modified pig to a person on Jan. 7, 2022.
To date, his pioneering, interdisciplinary initiatives have resulted in substantial advances in heart and lung transplantation-related methods and practices, 12 patents and three start-up companies. In addition to receiving millions in grants and contracts, numerous prestigious awards and honors have been bestowed on him for his scientific and entrepreneurial achievements.
In his lecture Saturday afternoon, Griffith plans to focus on “the critical shortage of human donor organs and the potential of xenotransplantation to bridge this gap … (so that Chautauquans) will gain insights into the science of genetically engineered pig organs, the ethical and clinical challenges of first-in-human trials, and the profound experiences of patients and families involved in these groundbreaking procedures.”
As he learned at Bucknell while striving to transplant hearts in rats, being willing to try and fail is essential to success.
“In trying and failing you get better at it, and you fail less,” he said. “You don’t innovate unless you can iterate.”
For Griffith, the future of heart and lung transplantation is “all very exciting.”
“What could be better,” he said, “than doing a transplant and having people live?”
