More than a year and a half after an organ that was kept warm and functioning in a machine was transplanted for the first time – a kidney at King’s College Hospital in London –, a team of surgeons in Sydney, Australia, has already performed three heart transplants with a similar technique.
Although doctors commonly preserve organs into ice before transplantation to prevent tissue breakdown occurring after being removed from the body, when the organ is a heart this process gets complicated. Heart tissue soon deteriorates after it is removed; therefore hearts have to be taken from brain-dead patients while the organ is still beating.
Now, a team at St Vincent’s Hospital in Sydney used a novel technique known as a “heart-in-a-box” to revive a heart that had stopped beating for up to 20 minutes. The doctors used blood from the correspondent donor to prime the machine. They remove the heart and submerged in a ground-breaking preservation solution jointly developed by the hospital and the Victor Chang Cardiac Research Institute. Then they connect it to a sterile circuit where they were kept beating and warm. The hearts were each housed in this machine for about four hours before transplantation.
Two of the patients who received the transplant have recovered well, while the third, who only undertook the procedure recently, remains in intensive care.
Cardiologist and unit director Peter MacDonald said the team had been working on the project for two decades and intensively for the past four years. “We’ve been researching to see how long the heart can sustain this period in which it has stopped beating,” he said. “We then developed a technique for reactivating the heart in a so-called heart-in-a-box machine.”
The team of researchers said the success heralded a “paradigm shift” that could save the lives of 30% more heart transplant patients by increasing the supply of suitable donors.
“Based on the performance of the heart on the machine we can then tell quite reliably whether this heart will work if we then go and transplant it,” said MacDonald. “This breakthrough represents a major inroad to reducing the shortage of donor organs,” he added.
Through: BBC News, The Guardian, The Independent
