Basil Chryssos knows a little bit about heart health as a practicing cardiologist in Carson City, Nevada. In addition to his medical education and clinical experience, he also had a personal history with heart conditions. His family originally hails from Greece, and his mother and grandmother both had heart issues. In fact, doctors had originally recommended that his mother get a heart transplant, but her condition ultimately stabilized with medications.
When he started experiencing some early symptoms of heart issues in his 40s and 50s, Basil wasn鈥檛 surprised. He saw a fellow cardiologist, who diagnosed him with cardiomyopathy and put him on medications for heart failure. When his health first took a turn for the worst in 2021, he was transferred to University of Utah Hospital by an AirMed helicopter for the placement of a pacemaker-defibrillator device. But even with multiple medications and an implantable defibrillator, Basil鈥檚 heart function continued to decline.
鈥淢y heart function was less than 35 percent, and I ended up with atrial fibrillation (Afib) as well,鈥 Basil said. He also had other heart rhythm issues throughout the years, including one cardiac arrest while using a snowblower鈥攊n that situation, the defibrillator saved his life by shocking his heart back to life.
What was intended to be a routine ablation for atrial fibrillation (AFib) was actually the start of Basil鈥檚 transplant journey. At the time of his arrival, he was critically ill with heart failure, and the evaluation revealed that his heart function had plummeted to about 10 percent. After his initial treatment to stabilize his heart function, he met with members of the heart failure and transplant team. That team included James Fang, MD, Chief of Cardiovascular Medicine at the Spencer Fox Eccles School of Medicine at the University of Utah and Director of the cardiovascular services at U of U Health.
A Life-Saving Decision: Dual Transplant at U of U Health
鈥淒r. Chryssos had a known diagnosis of heart failure that was worsening despite the best medical and surgical therapies,鈥 Dr. Fang said. Doctors knew that a transplant was really the only option that could offer Basil a chance at living longer and enjoying quality of life.
While doctors can use criteria to determine who is a good candidate for a heart transplant, it鈥檚 difficult to know the right time to move forward with that option, Fang said. In some cases, other options exist: a permanent implantable heart pump, investigational medications, research studies. Some patients do not want a transplant for religious, financial, or personal reasons, and may choose palliative care instead.
鈥淲e do have some criteria and our personal experience treating heart patients to anticipate the trajectory of this condition,鈥 Dr. Fang said. 鈥淲e knew that someone in heart failure who was not responding to surgical and medical device therapies would have a high chance of mortality in the next one or two years, so a transplant is probably their best definitive option.鈥
Presented with the information, Basil decided to move forward. In addition to his heart transplant, the doctors also recommended a kidney transplant. 鈥淗eart and kidney problems often occur together鈥攊n medical terms we call it cardio-renal syndrome,鈥 Dr. Fang said. While multi-organ transplant isn鈥檛 common, in some situations, it鈥檚 the best option for a good long-term outcome.
If Basil got a heart transplant and then had kidney failure and needed dialysis for the rest of his life, it could put added stress on his donated heart with increased risk for many complications. 鈥淭he decision to go ahead with a second organ transplant in a single patient is weighed heavily,鈥 Dr. Fang said. 鈥淔or example, there are ethical considerations that we must take into account鈥攊n this case, one patient is getting two organs, rather than two people getting one organ each.鈥
Once a patient makes the decision to move ahead with a transplant, the next step is getting on the list to wait for an appropriate donor. The average time to get a transplant varies, Dr. Fang said. For some, it could be just a few days; for others, it could be several months or even years.
Organ donation is managed by the non-profit (UNOS), which maintains the list of patients in need of transplant. When an organ becomes available, they identify eligible patients based on criteria such as how well they match with the donor, how sick they are, and how many donors are available in the local area compared to the number of patients waiting.
Most organ donations are regional, because transplants are most successful when travel time is limited. A donor heart, for example, is only viable for about four hours before it will show signs of stress from lack of oxygen, and doctors won鈥檛 be able to revive it. While new technologies can extend these times, finding a regional organ donor remains the best option for most patients.
Being on an organ donation waitlist isn鈥檛 like waiting in line at the grocery store, though, where the first people in line are the first through the checkout. For heart transplant specifically, the UNOS has a six-tier transplant allocation system () that aims to get hearts to the sickest patients who have the highest risk of death while waiting for an organ donation. Kidney transplants have a similar prioritization based on compatibility and medical urgency.
Since Basil鈥檚 heart function was extremely poor, he was high on the list when an appropriate heart and kidney became available. He had been careful throughout the years to maintain his health, ensuring that he would be physically ready when the time came for a transplant.
The transplant team at U of U Health notified Basil as soon as his donor organs were available, and the heart and kidney transplant surgeries were performed in July 2023.
"On my way from my room to the surgical suite, the only thing going through my mind was the Lord鈥檚 prayer; I believed my fate was in God鈥檚 hands,鈥 Basil said. 鈥淥ne of my daughters even postponed her wedding鈥攚hich was going to be in Greece鈥攂ecause she wanted me to attend the wedding, and she wanted to be with me during my recovery.鈥
Recovery, Resilience, and Gratitude
That recovery was challenging. Basil was in the intensive care unit (ICU) for several weeks. Immediately after the surgery, he remembers very little. He was delirious from medications and metabolic derangements (disruptions in the body's normal chemical processes) that often occur after open heart surgery.
Furthermore, his team said he would need temporary dialysis to manage these disruptions, along with the extra fluid he accumulated after surgery, until his new kidney could take over. All of that was on top of the challenges his body was already facing trying to integrate two new organs and avoid rejection.
He started physical therapy even before the transplant to try and prepare his body but still had trouble getting out of bed following surgery and couldn鈥檛 stand for more than about 30 seconds at a time. One of his daughters stayed with him that summer to help clean his wounds and put new bandages on each day, a necessity for avoiding infection.
Dr. Fang said that some heart transplant patients come out of surgery feeling like they got hit by a truck. On top of the physical pain, nausea, vomiting, and limited mobility, patients also experience an emotional and psychological recovery. For some, that includes depression and struggling with the perceptions of organ donation, including the knowledge that someone else鈥檚 life had to end to get that organ and continue your own life.
Despite all the setbacks, Basil didn鈥檛 give up. After being transferred from the ICU to the regular cardiac floor, he was then released to the Craig H. Neilsen Rehabilitation Hospital at the University of Utah, where he worked hard at things that once seemed very basic but suddenly became difficult, like standing up from a seated position. When he recovered enough to leave the rehab center, he got an accessible apartment and attended outpatient rehab three days a week.
鈥淭here are so many things that seem simple when you are healthy but become very hard as you recover from transplant surgery,鈥 Basil said. 鈥淔ortunately, I had access to some phenomenal physical therapists and some of the best facilities at U of U Health to get me back on my feet.鈥
By February 2024, he was well enough to go home to Nevada. To continue building his strength, Basil walked every day鈥攅ven when his medications caused some back issues that affected his mobility.
In Summer 2024, he attended his daughter鈥檚 beautiful wedding in Greece. Basil was grateful to dance with her at the reception, but at the end of his trip, Basil got pneumonia and ended up in a Greek ICU for 12 days. On his way back home, he flew into Salt Lake City and stopped at U of U Health for an echocardiogram. Pneumonia after a heart transplant can be dangerous; the transplant team wanted to make sure his body wasn鈥檛 rejecting his donor organs. They found his cardiac function slightly decreased, but everything else checked out.
Today, he鈥檚 doing well, and even went back to work in 2024. He sees patients in the office, all of whom must be screened to make sure they don鈥檛 have an illness that could compromise his health. When he鈥檚 not with patients, he helps handle the phones for the other cardiologists at his practice. 鈥淚鈥檓 very grateful to my employer, Carson Tahoe Regional Medical Center, who provided me with excellent medical insurance that covered my transplant,鈥 Basil said. 鈥淭hey also allowed me to take an extended medical leave, which helped me to return to work seamlessly.鈥
鈥淚 think a lot about the fact that I have another person鈥檚 heart and kidney inside my body,鈥 Basil said. 鈥淭hat is a tremendous gift to give me a chance to continue living my life and being with my family. I certainly don鈥檛 take it for granted.鈥
At 69 years old, he is thrilled to have just become a grandfather for the first time, and he wants to continue working with cardiology patients for a few more years before retirement.
鈥淚 am so grateful to the team at U of U Health鈥攅veryone from the surgeons and the transplant team care coordinators to the rehabilitation providers,鈥 Basil said. 鈥淭hey all worked so well together to not just get me back to life but back to a high-quality life. I鈥檝e seen medicine from the provider side for many decades. Seeing it from the patient side was different, but everything at U of U Health was amazing.鈥
7 Questions for a Cardiologist
On this episode of Seven Questions for a Specialist, cardiologist John Ryan, MD, answers what he thinks is the best鈥攁nd worst鈥攖hing you can do for your heart, why he chose to specialize in cardiology, and what advancements he's most excited about in the field of cardiology.
