Article by Lauren Barker
(first published on Central Adelaide Local Health Network)
Lyall Pearce was feeling fit and healthy, having just celebrated his 50th birthday.
“My grandmother lived to 101, so I was thinking I had about another 50 years left,” the husband and father of two from Hillcrest said.
But when the ride to work he did every day suddenly became a struggle, he felt something was wrong.
“I used to ride my bike every day to work about 9-10km, rain or shine. I found it started to get more and more difficult to get up a hill along the way.”
After seeing his GP and being referred to a thyroid specialist, he was finally diagnosed with Multiple Myeloma with secondary cardiac amyloidosis (due to the toxic protein produced by the myeloma cells), and given an 18 month prognosis.
That was in 2015.
Although Lyall had numerous hospital admissions and side-effects, he initially responded well to chemotherapy under the care of by haematologist Dr Noemi Horvath.
But the impact of the chemotherapy treatment and the infiltration from the amyloidosis in his heart had severely impaired his heart’s function.
Doctors installed a pacemaker and he began heart medications, but by mid 2020 his situation was dire and had developed resistant heart failure despite numerous medical interventions.
Lyall was essentially bed-bound and unable to move without becoming breathless and his other body organs had started to be compromised due to his extremely poor heart function.
During an admission to the Royal Adelaide Hospital in June 2020, Lyall was flown urgently to St Vincent’s Hospital in Sydney where he waited for a heart transplant.
As his clinical status deteriorated, to bridge him during this wait, the team at St Vincent’s Hospital installed a specialised mechanical cardiac device called an Impella Device.
*Pictured are Lyall Pearce with Dr Michael Stokes.
An Australian first
“He is the first person in Australia to have a short-term Impella pump implanted while supporting him to an urgent heart transplant,” CALHN cardiologist Dr Michael Stokes explained.
“Some patients may have much longer periods of mechanical cardiac support with a ventricular assist device (LVAD), but this wasn’t a viable option for Lyall.
“The Impella is used very rarely, usually in patients recovering from a large heart attack for a few days. It’s only been used a very small number of times in Australia.”
Four days later on July 1, Lyall had a heart organ donor match, and he was one of the first myeloma-related amyloidosis heart transplants performed in Australia.
“Lyall has taken part in a number of clinical trials and he was able to get compassionate access to an anti-plasma cell antibody (called Daratumumab) that has shown promising results in myeloma patients,” Dr Horvarth said.
“This was successful in keeping Lyall’s toxic protein production under control for 18 months.
“In spite of that, his heart function continued to deteriorate so it was fortunate that he was eligible for the subsequent treatment he received.”
Lyall spent several weeks in ICU and then on the ward at St Vincent’s Hospital, but is now back home recovering and relatively independent.
“We think he is going really well and we are optimistic,” Dr Stokes said.
“He’s five months post-transplant and requires long-term immunosuppressive therapy. “
While still battling amyloidosis, Lyall has new goals to achieve.
“It’s just a matter of being able to get my fitness back. I’d like to get on my bike again.”
He is also hoping to get back to work next year at DXC Applications where he has worked as a support specialist for 20 years.