UH Cardiothoracic Transplant Director Improves Quality and Volume, Innovates with “Heart-in-a-Box” Technology

UH Clinical Update | April 2024

UH cardiac surgeon Yasir Abu-Omar, MD, has performed hundreds of heart transplants, both here and in the U.K.

Yasir Abu-Omar, MD

But he says the case of one particular patient stands out.

This relatively young person arrived at UH Cleveland Medical Center near death. “The patient was essentially dying because of a major low cardiac output, and was in heart failure with arrhythmia,” Dr. Abu-Omar recalls.

The patient’s situation was so dire that Dr. Abu-Omar led the team in putting them on ECMO – essentially a heart-lung machine -- to buy time. And they listed the patient for transplantation.

Just two days later, the patient received a heart transplant. A year later, this patient reached another milestone – their wedding, where Dr. Abu-Omar was in attendance. He even brought along some colleagues who were involved with the patient’s care.

Stellar Performance

This kind of connection to patients, paired with unparalleled clinical expertise and innovation, characterize Dr. Abu-Omar, says Mehdi Shishehbor, DO, MPH, PhD, President of UH Harrington Heart & Vascular Institute and Angela and James Hambrick Chair in Innovation. Although Dr. Abu-Omar has just been in his role as Director of Cardiothoracic Transplantation and Mechanical Support and Lincoln Chair in Cardiothoracic Innovation since 2020, Dr. Shishehbor says he has already implemented major advancements to both programs.

Volume and quality, for example, are both up.

“The quality of the transplant program under his joint leadership along with Eiran Gorodeski, MD, Director, Advanced Heart Failure and Transplant Center and Daniel I. Simon, MD, Chair in Cardiovascular Excellence, delivered the largest number of transplants performed in one year, but more importantly, achieved substantial improvement in quality in terms of survival after heart transplantation and significant reduction in morbidity,” Dr. Shishehbor says. “The improvement in results following implantation of left ventricular assist devices have paralleled that of transplantation, making UH a center of excellence for heart failure therapies.”

UH CEO Cliff A. Megerian, MD, FACS, Jane and Henry Meyer Chief Executive Officer Distinguished Chair, recently recognized Dr. Abu-Omar for this exemplary work with a “Dinner with the Doc” honor.

Innovating to Expand Transplant Access

Adding to these accomplishments have been the arrival at UH of several innovations in heart transplantation, including a more regulated and effective system for cold storage, shepherded by Dr. Abu-Omar. But he says the real breakthrough has been in expanding the universe of possible heart donors and implementing next-generation technology to preserve and perfuse hearts awaiting transplant.

To that end, Dr. Abu-Omar’s team is now performing heart transplants from donors with declared circulatory death rather than declared brain death. Circulatory death donors do not meet full brain death criteria, but have suffered devastating, irreversible injuries and further care is futile. The heart is recovered after a period of asystole and reanimated on the TransMedics organ care platform.

“This is what is called heart-in-a-box,” Dr. Abu-Omar says. “The heart is mounted in a device where it receives nutrients and blood and oxygen. The heart will actually be beating on transport, so it will not sustain any loss of oxygen, or what we call the ischemia deprivation. Nobody has done this before because they felt that if the heart stops, how can you revive the heart and transplant? But we demonstrated that this is something that is possible if you take the heart out quickly enough. You put it on the heart in the box and perfuse the heart, and the heart will start beating again.”

Already, Dr. Abu-Omar and his team have successfully performed a handful of these transplants – with more to come.

He says this and other projects – and an overall ability to innovate -- validate his decision to relocate to Cleveland and UH Harrington Heart & Vascular Institute four years ago.

“I’m delighted to live my life here,” he says. “Another 100 out of 100 times, I'll select to come to Cleveland and UH. I love it.”

To nominate a physician for this honor, click here for the UH "Dinner with the Doc" Nomination Form. The next deadline is May 2.