Local heart transplant patient raises awareness for Gibraltar Cardiac Association

Heart transplant patient Louis Casciaro received the life-saving operation after years of ill health. Now three years after the transplant, one of the doctors overseeing his surgery, Dr Clive Lewis, will be in Gibraltar to raise awareness on 50 years of heart transplantations.
The lecture is part of the Gibraltar Cardiac Associations ‘heart month’ awareness campaign.

Louis Casciaro had grappled with cardiac issues for some 16 years before receiving the vital heart transplant.

The former Chief Fire Officer was one of the first in the Royal Papworth Hospital in Cambridge to have a new procedure where a ‘dead’ heart was transplanted.

The Royal Papworth Hospital is a leading heart and lung hospital and was home to the world’s first successful heart, lung and liver, and one of the world’s first non-beating-heart transplants.

At 58-years old Mr Casciaro was the 18th person to receive a non-beating-heart transplant at the Royal Papworth Hospital. Now some 50 non-beating-heart transplants have successfully taken place at this hospital.

Dr Clive Lewis was one of the doctors that treated Mr Casciaro throughout and after the heart transplantation. He will be arriving on the Rock to give a presentation on heart transplants.

Dr Lewis, a cardiac transplant physician from the Royal Papworth Hospital, specialises in advanced heart failure, cardiothoracic transplantation, mechanical circulatory support and congenital heart disease.

Mr Casciaro is a member of the Gibraltar Cardiac Association that was formed two and a half years ago. He asked Dr Lewis to give a presentation in Gibraltar
“I have been a cardiac patient since 1990,” said Mr Casciaro.

“I was very young, and I had a couple of MIs [heart attacks] when I was 33.”

He was treated by angioplasties which open blocked arteries and was declared fit to continue working.

Mr Casciaro was told he had scarring in his heart and went on to live a relatively normal life for 12 years.

“My problems started coming back in 2004 and 2005 when I was inserted with an implantable cardioverter defibrillator and was diagnosed with acute cardiomyopathy,” he said.

Acute cardiomyopathy is a disease where the heart becomes enlarged resulting in heart failure.

Without a new heart Mr Casciaro life-expectancy would be drastically reduced.

This diagnosis led to Mr Casciaro’s heart transplant in 2016.

“My ejection fraction, this is how they measure heart rates, was supposed to be within 48 to 50%. Mine was at 23% at the time and then it came down to 6%. That is when I was put on the transplant list.”

“Basically I was terminal. I was told the only solution was to have a heart transplant.”

An implantable cardioverter defibrillator was inserted. When the heart goes out of rhythm it would give the person a shock to bring the heart back in rhythm.

“At first I was having an episode once a year which was normal, but then I started having daily episodes.”

“It was two or three times a day and that was really painful. It’s 12 volts right against the heart so it can be quite impressive.”

Mr Casciaro was placed on the heart transplant list on June 1, 2016 and just two weeks later he was moved to the urgent list.

“I was told in the original transplant list that it would take about four years, but then I got worse and was put in the urgent list and within six weeks I had the transplant.”

With his ill deteriorating and waiting for a donor, these were very stressful times for Mr Casciaro and his family.

He remembers how he met a 37-year old man, a patient at Royal Papworth Hospital, who was also waiting for a heart transplant. Unfortunately he passed away before an eligible donor was found.

Mr Casciaro lived within 15 minutes of by Royal Papworth Hospital for 14 months due to the aftercare of the heart transplant.

Before having the heart transplant Mr Casciaro was taking 18 pills a day and now he only takes immune-suppressants and blood pressure tablets.

In a bid to give thanks and find out more about his donor Mr Casciaro wrote to the family through their transplant co-ordinator.

The answer they received that their donor was a man from the East Anglia and in his mid-30s.
“We never received any more information.”

He added: “My children, my family and myself are forever thankful for this.”

Typically heart transplants would take place when the donor was in a coma. The donor would be declared brain dead but the heart would still be pumping. The heart would then be taken for transplantation.

But Mr Casciaro was one of the first patients at Royal Papworth Hospital was have a new procedure.

For his transplant, the donor was declared dead and the heart had to be physically stopped for over five minutes. Then specialist doctors would restart the heart and prep it for transplantation.

“The results up to now have been encouraging,” he said.

“I was so stressed out and fighting for my life and then I had to digest so much information. When you’re at that stage you will be put yourself down for anything.”

“It is very emotional. I have never been an emotional person myself, I have always been in a disciplined service like the fire service all my life. But it made me very emotional after the transplantation.”

The lecture by Dr Lewis will take place on February 1, 11am at the University of Gibraltar. There will be no entrance charge but people are requested to contact the university in advance to register their attendance.