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Risky Business
Within the first year, especially the first six months, a patient is at the highest risk for rejection. Rejection is one of the leading causes of death during that time, according to the National Heart, Lung & Blood Institute; nationally, about 12 percent of heart-transplant patients die because of it.

To control rejection, Budge prescribes immunosuppressant medications as well as aspirin, cholesterol medication, calcium and vitamin D pills. The patients continue to take these pills every day for the rest of their lives, although the doses are periodically lessened with time.

Patients also experience adverse side effects from these medications. The most common side effects are tremors, nausea, high blood pressure and diabetes.

For Mader, yet another adverse effect is the cost of the medications. He is currently raising money on the donation website GoFundMe to help shoulder some of the hefty costs.

The cardiologists at Intermountain Medical Center also test patients for rejection with biopsy monitoring. About 20 or 25 times in the first year, doctors take a small amount of tissue from the new heart to see if it is remaining compatible with the body. This lessens to four times the second year, three times the third year, two times the fourth year and once every year after.

Peterson’s surgery was further complicated by inflammation and scarring because of the artificial heart’s plastic pump, which the body regards as a foreign object. His surgery took around eight hours for operating-room staff to carry out, and he spent 15 days in the hospital recovering.

For Peterson, the worst part of being back on a regular heart was the fear. For the first four months with his transplanted heart, he says, he constantly worried about returning to past heart complications. But over time, Peterson began to trust that the new heart would not fail him.

Mader’s biggest reminder of his survival is in his scars. He estimates there is about 2 1/2 feet of scarring across his body, including a prominent scar resembling the Mercedes symbol.

“The day I got the scars is the day I was given a new life,” he says. “It was a lifelong battle, and the scars are a daily reminder that life is fragile.”

Once the scars have healed, the risk of rejection decreases, but yet another complication arises—the risk of malignancy or complications from the medications, making a heart transplant a lifelong healing process.

“With a transplant, you almost trade one disease for another,” Budge says. “It’s not that transplant is a disease, but it requires all of these medications and monitoring. It’s something that’s there every single day. You can’t ever forget you’re a heart-transplant patient.”

Uncertainty and living day by day is something Budge is reminded of every day. She may not wear her heart on her sleeve, but she wears something awfully close to it around her neck: a thin silver necklace with three circle pendants. It represents “the hardest and also the best time” of Budge’s life, she says.

During her internal-medicine residency years ago, she worked with a group of aspiring practitioners like herself; they all forged strong relationships by learning together.

In 2012, a member of the group, a physician, died “tragically and suddenly,” Budge says. He was a father, a husband and, as Budge recalls, “a prince of a man.”

After the incident, Budge reconnected with some members of the group to remember him. During the memorial trip, she purchased the necklace to wear as a daily reminder that life is short.

The experience, she says, made her realize “how privileged I am to be able to do the work I do helping others.”

Courtney Tanner is news editor at The Daily Utah Chronicle, the student paper of the University of Utah, where Tanner is a junior studying journalism, English and political science.

Organ Donation

• 1 name is added to the national organ-donor waiting list every 10 minutes.

• On any given day, approximately 3,000 people in the United States are on the waiting list for a heart transplant. About 2,000 hearts become available in the average year.

• An organ donation is possible only when someone is declared brain dead (sometimes after a cardiac death). Brain death is not common, and thus useable organs are rare. The person also has to be registered as a donor. This is the case in only 2 percent of deaths.

• 1 organ donor can potentially save 9 lives.

• 70 percent of eligible Utahns are registered as organ donors.

Sources: The U.S. Department of Health & Human Services; the National Heart, Lung, and Blood Institute; Yes Utah; Intermountain Donor Services

Becoming an Organ Donor

•Register on YesUtah.org or check the box when renewing or applying for a Utah driver’s license.