By Jeff Kelley

Ben Pastva is a heart transplant recipient. “But this does not define who I am,” he said.

He’d instead like to be defined, in part, for what he did in February. Less than three years after his September 2021 heart transplant, Ben broke Randolph-Macon College’s decade-old 50-meter freestyle record at the Division III championship meet: two laps in 20:99 seconds.

“He’d had his eye on that record since the day he started at Randolph-Macon,” said his mom, Kelly Weaver.

It was a long road there, and one that began during three weeks in the summer of 2021 at VCU Medical Center.

“It happened super fast,” Ben, now 22, reflected. “And it wasn’t something I want to remember, but it’s gonna stick with me the rest of my life.”

A mother and son’s intuition: ‘Something was definitely wrong’

At his high school in Fairfax, Ben was an elite-level sprinter on the swim team.

But as a freshman, he remembers getting sick with pneumonia-like symptoms, which took him out of school for two weeks. During senior year, he experienced waves of fatigue and shortness of breath — enough to raise a red flag, but not enough to visit a specialist for deeper evaluation.

“We knew nothing. My friends never noticed what was going on,” he explained, “but there was definitely something wrong.”

He arrived at Randolph-Macon in Ashland in fall 2020 and joined the swim team. But that was the COVID year, when teams weren’t competing beyond intra-squad events. He was still fast, but over time, his athleticism began to falter. By spring, he could barely finish a practice — out of breath, moving at slower speeds. “I felt horrible,” Ben said.

After freshman year, he swam and competed in a Northern Virginia league, but late that summer, Ben’s health went downhill. Up at 2 a.m. vomiting. He couldn’t eat or sleep. When dropping her son off for his sophomore year, Kelly told him he needed to go to a doctor.

“He’s an elite athlete, and I knew when he agreed so quickly to go to the doctor that something was definitely wrong,” she said.

After first going to an urgent care clinic in Ashland, Ben was transferred to a Henrico County emergency department and soon went into cardiac arrest. They moved him to VCU Medical Center, where he was stabilized.

For Ben, and all our transplant patients, we never leave even the smallest detail to chance. In Ben’s case, our efforts paid off and he had a textbook surgery and recovery. Knowing he can make the most out of his second chance at life brings me unbelievable joy.

Mohammed A. Quader M.D., VCU Health Hume-Lee Transplant Center

Physicians at VCU Health diagnosed Ben with dilated nonischemic cardiomyopathy — a weakened and enlarged heart that wasn’t properly contracting.

“Nonischemic means his heart problems weren’t caused by heart attacks or coronary artery disease. There are conditions, either genetic or unidentified, that can cause heart failure in young patients. There’s still a lot we don’t know but are actively researching,” said Keyur B. Shah, M.D., the section chief of advanced heart failure at VCU Health Pauley Heart Center, and Ben’s cardiologist.

Weak hearts can’t deliver blood to vital organs or handle a high volume of fluids, causing shortness of breath, fatigue, swelling in the legs and stomach, and other symptoms. Ben’s heart had weakened so much that he had signs of end-organ damage that put stress on his kidneys, liver, and muscles that were releasing lactate due to lack of oxygen.

His care team placed Ben on extracorporeal membrane oxygenation, or ECMO, a last-resort treatment that uses a machine to take over heart and lung function when a patient's organs don't work on their own.

Shah and the team also broke the news to Ben and his parents: To survive, he’d need a heart transplant.

“My dad and my mom were shocked,” Ben said. “I didn’t really care — I just needed to get out of there alive at that point.”

Because he was on mechanical life support, Ben was put on the national heart transplant waiting list’s “Status 1” level — the top. Less than two weeks after arriving at VCU Health, he received a heart on September 11, 2021, in a surgery performed by cardiothoracic surgeon Mohammed A. Quader, M.D., at VCU Health Hume-Lee Transplant Center.

“After seeing the emotional impact Ben’s diagnosis had on his family and him, I wanted to ensure his surgery was not just perfect, but better than perfect,” Quader said.

What are your options after being diagnosed with advanced heart failure? Listen to Keyur Shah’s interview on the Healthy with VCU Health podcast

The care team overseeing Ben’s surgery was made up of esteemed heart failure and transplant specialists from Hume-Lee Transplant and Pauley Heart centers, both renowned for pioneering surgical techniques and technologies, and for excellent outcome records.

Since Ben’s transplant, VCU Health has reached a milestone of 800 heart transplants since the program was established in 1968.

“For Ben, and all our transplant patients, we never leave even the smallest detail to chance,” Quader explained. “In Ben’s case, our efforts paid off and he had a textbook surgery and recovery. Knowing he can make the most out of his second chance at life brings me unbelievable joy.”

“Within eleven days, we went from dropping off an elite college athlete for his sophomore year to having a kid with a heart transplant,” Kelly said.

Ben regained his stamina and walked out of the hospital just nine days after surgery.

The unbelievable joy of success post-transplant and in the pool

By November, only two months post-surgery, Ben was back in the pool swimming laps.

“I felt so different, so much better. I had more power in my stroke,” he recalled.

He spent the fall semester in recovery and returned to Randolph-Macon in January, where he balanced his recovery —  including taking immunosuppressants to resist rejection —  with academics and training.

It was such a small amount of time, but carried with it such a huge impact…Then you add in the emotional toll of going through everything [Ben] had. It was very emotional. You just couldn't ask for a better kid to get that record.

Brent Kintzer, head swimming coach for Randolph-Macon College

For pediatric and young adult patients who receive a heart transplant, there’s high risk post-surgery in terms of medical compliance due to rapid life changes: leaving home, going to school or starting work, getting married, and changing social infrastructure and routines. That can result in missing medications, deviating from a strict medical plan, and missing regular clinic visits or lab work visits. Young people, even transplant recipients, often have feelings of immortality, Shah says.

“We are very in-tune to these life changes, because it can increase the risk of having a rejection,” Shah said. “We hammer in, before and after transplants in younger patients, that managing their transplant is a full-time job. If you want a heart transplant, you have to accept that this is for life.”

But Ben has done so, his mom says.

“He grasps that this is just what he has to do, and he does it. He has taken charge of keeping up with his medications, filling his pill box, following a schedule —  which is way beyond his years,” Kelly said. “He’s doing it entirely on his own.”

There have been setbacks — “trainwrecks,” in Ben’s words. In early 2022, he was hospitalized and treated for a mouth ulcer, likely due to a combination of immunosuppressive drugs and a viral infection. During the February 2023 championships, he slammed his arm into the pool wall and broke it.

But he kept pushing.

After his transplant and while in recovery, Ben “became a huge source of inspiration for our team,” said Brent Kintzer, Randolph-Macon’s head swimming coach who recruited Ben to the school. “There was a lot of checking in just to see how he's feeling, letting him rest, allowing him to relax and adjust to his new scenario as best as he possibly could.”

 I'm gonna keep myself exercising, and I'll keep making people happy. I was depressed getting out of the hospital, and I’ve been wanting to change myself a lot. I'm not sick anymore. I don't need to be held back by my own heart.

Ben Pastva, VCU Health patient

Even at the end of his 2023 season, Ben was within one-tenth of a second of beating the school’s decade-old record of 21 seconds flat for the 50-meter freestyle. Then came the broken arm.

“He was frustrated, but incredibly motivated coming out of that,” Kintzer said. “He trained a lot harder leading up to the 2024 championships knowing what he had to do.”

This February at the Old Dominion Athletic Conference Championships, Ben’s longtime goal became a reality. He broke Randolph-Macon's record by one-one hundredths of a second: 20.99.

“It was such a small amount of time, but carried with it such a huge impact. It’s one of those things, as a swim coach, where you know an athlete wants to do something and when they finally do it, you're just overjoyed for them. They touch that wall and then turn their head and look at the clock, and realize they've done what they've set out to do for years,” Kintzer recalled. “Then you add in the emotional toll of going through everything he had. It was very emotional. You just couldn't ask for a better kid to get that record.”

Witnessing Ben’s achievements so soon after such a lifechanging diagnosis and surgery, Shah says, is remarkable.

“He’s an athlete — period,” Shah said. “In general, we hope that when someone undergoes a heart transplant, they go back to the quality of life that they want, or were at previously, or at least get close. We don't want patients to put themselves in a position where they can acquire infections, especially early after transplant. But you can return to quite a bit of normalcy.”

As for Ben’s own outlook? He’s got a lot on his mind: An internship, hopes for the future, and a lot of good things coming his way.

“I don't want to mess things up. I want to keep myself healthy,” Ben said. “I'm gonna keep myself exercising, and I'll keep making people happy. I was depressed getting out of the hospital, and I’ve been wanting to change myself a lot. I'm not sick anymore. I don't need to be held back by my own heart.”