Surgeons successfully transplant a heart that had stopped beating
In a world first, surgeons at St Vincent’s Hospital in Sydney, Australia have successfully transplanted a "dead" heart into a patient. Thanks to the use of a revolutionary preservation solution, developed by the Victor Chang Cardiac Research Institute and St Vincent’s Hospital, the doctors were able to resuscitate and transplant the donor heart after it had stopped beating for up to 20-30 minutes.
It just so happens that as I'm writing this article a very good friend of mine is waiting on the national emergency transplant list for a heart. It was a huge relief to learn that he would go on the top of the transplant list, before I was to later learn just how difficult it is to find a suitable donor heart. At present (and my friend's case included), transplant units can only accept donor hearts from patients hooked up to life-support machines and are clinically brain dead, eliminating potential donors whose life-support is switched off while they have a limited brain function.
"[With] patients that have only a tiny little bit of brain function left, [...] once life support is turned off and the heart has stopped beating, by Australian law surgeons have to wait five minutes before they can legally take the heart out for transplantation," Professor Bob Graham, Executive Director of the Victor Chang Cardiac Research Institute tells Gizmag. "The heart is gradually deprived of oxygen for up to 20-30 minutes, which causes enormous amounts of damage to the organ. Previously it was thought that this damage was irreversible and so the hearts were unsuitable for transplant. But thanks to the preservation solution and the Organ Care System (better known as the 'beating heart in a box' machine), the heart can now be revived. The heart can be kept warm and beating on the machine for up to 8 hours. The machine is portable so it can be taken to any hospital in Australia."
The new technique is the outcome of a 20 year research effort, which included 12 years to perfect the preservation solution and an another five to six years to combine it with the Organ Care System. The preservation solution consists of three different drugs that are injected into the heart, preserving it for a limited amount of time while it is no longer pumping.
"This cocktail of drugs makes the heart more resistant to the damage that is caused because of the lack of oxygen," says Professor Graham. "It makes the heart more resilient to transplantation. It also reduces the number of heart muscle cells that die. It improves heart function when it is restarted as well."
To date St Vincent’s Hospital has successfully transplanted three hearts using this technique and hopes it will be quickly adopted by other hospitals around the world.
"All three patients that we've transplanted are doing very well," reports Professor Graham. "The first patient is about 3 months post transplant. She has been home for about 2 months and feels better than ever. The second patient is now 2 weeks out and he’s walking around and feeling wonderful. And the third patient is still in the intensive care unit but has had no major problems. Now that the rest of the world knows about it and now that we have reported on these cases, there’s no reason to stop other very experienced transplant units from using this technique tomorrow."
According to the Victor Chang Cardiac Research Institute, the breakthrough could see the amount of successful heart transplants rise by 30 percent, while also allowing countries like China to perform the procedure (currently China does not perform heart transplants, because its definition of death is "heart" death).