During the first two years of the infant heart transplantation program, Loma Linda University Medical Center sent a patient-transport team to bring prospective donor babies back to Loma Linda. In many cases, Dr. Leonard Bailey, the pioneer infant heart transplant surgeon himself went. The procurement and transplant then took place in adjoining operating rooms. Infant donors came from Syracuse, New York, Toronto, Canada, and from other parts of the United States.
Then, an interesting development in organ procurement took place which changed that: multi-organ procurements. Now, at least two patients can receive life-saving organ transplants from one donor. Conceivably, as many as eight.
Now, whenever a donor becomes available, a transplant surgeon flies to the donor hospital, procures the organ in cooperation with other organ procurement teams, and returns to Loma Linda. This development led to a logistics problem for the Loma Linda heart transplant team. With adult hearts, scientists believed the longest ischemic time (that is, the time an organ is without a blood supply) was about four hours. After four hours, possible damage from lack of oxygen could occur. And there is no way the Loma Linda infant heart transplant team could bring only the tiny organ, weighing about one ounce, back to Loma Linda from the East Coast, and do everything in four hours.
So, Dr. Bailey’s team had to develop ways to protect these tiny organs for longer periods of time. And in so doing, they lengthened the time available for successful infant heart transplantation incrementally, over time, to five hours, six hours, seven, eight, nine, ten, almost ten and a half hours—way more than double what was once thought to be the maximum amount of ischemic time for heart transplantation. And in so doing, they literally opened the State of Alaska for organ procurement. They have been all the way to Anchorage—and even farther, to Halifax, Nova Scotia—and even farther, to San Juan, Puerto Rico, to save a baby’s life in Loma Linda.
The total effort has sometimes involved a hundred people: from Medical Center administrators, social workers, chaplains, and registered nurses, to ethicists, anesthesiologists, jet pilots, air traffic controllers, and transplant surgeons—all working together in a huge, coordinated effort to try to save the life of one little person, a stranger. (Because time is of the essence, the nation’s air traffic controllers give take-off and-landing priority to Loma Linda jets.)
Another improvement in the program was to bring the prospective recipients, at least those from far away, to Loma Linda before a donor has been located. This change in procedure avoids delays and red tape in arranging last-minute transportation. The situation of Ann-Marie Gagnon is a case in point. At 2 pm one day, Ann-Marie Gagnon, from Quebec, Canada, was notified of an available heart for her daughter, Genevieve. At 4 pm the Royal Canadian Mounted Police whisked her through customs and immigration, to board an Air Canada jet for California. Bringing the babies to Loma Linda well in advance of a possible heart transplant has reduced stress for all concerned.
The cooperation of the United States Air Force has contributed significantly to the program. The former Norton Air Force Base, a Military Airlift Command Base, is only about ten minutes by ground ambulance from Loma Linda. The Air Force in the past has been a vital part of the team effort that makes a transplant successful. The benefit has been mutual. Several of the transplant babies were military dependents—two of them flown in from England.
In May, 1990, Loma Linda University Medical Center became the only California hospital to be approved by Medi-Cal and California Children's Services to perform pediatric heart transplants. In a letter of approval, T. G. G. Wilson, MD (Chief of the Medical Policy Section of the Medi-Cal Benefits Branch), wrote to Dr. Bailey, “We much appreciate your dedicated efforts on behalf of all the children you treat and your interest in serving Medi-Cal and CCS beneficiaries. We look forward to a long and cooperative relationship.” In 2005, Loma Linda University School of Medicine awarded Dr. Bailey the rare Distinguished Professor faculty appointment.