In a world first, doctors transplant a ‘dead’ heart that had stopped beating.

Australian surgeons state that they have used hearts that had stopped beating in successful transplants, in a world first that could change the way organs are donated.  Until now, doctors have relied on using the still-beating hearts of donors who have been declared brain dead, often placing the recovered organs on ice and rushing them to their recipients.

But Sydney’s St Vincent’s Hospital and the Victor Chang Cardiac Research Institute have developed a technique which means hearts which had been still for 20 minutes can be resuscitated and transplanted into a patient.  The new preservation technique is expected to save thousands of more lives by providing more hearts, which were in the past deemed unsuitable and/or too starved of oxygen to transplant.

So far three people have received hearts in this way, with two recovering well and the third and most recent recipient still requiring intensive care.

The donor heart wasn’t beating for up to 20 minutes before it was resuscitated and successfully transplanted.  The heart was brought back to life, then placed on a machine, before it was injected with a ground breaking preservation solution, developed by the Victor Chang Cardiac Research Institute and St Vincent’s Hospital.

It’s believed 30 percent more lives will be saved using this new technique.  The preservation solution, which took 12 years to perfect, was found to reduce the amount of damage to the heart, making the heart more resilient to transplantation.  The team also noted that the preservation solution reduced the number of heart muscle cells that died and improved heart function when it was restarted, having limited damage from a lack of oxygen.

Researchers know that within a certain period of time the heart, like other organs, can be reanimated, restarted, and only now have the team in the current study been able to do it in a fashion whereby a heart that has stopped somewhere can be retrieved by the transplant team, put on the machine and then (surgeons can) transplant it.

The technique involves donor hearts being transferred to a portable machine known as a ‘heart in a box’ in which they were placed in a preservation solution, resuscitated and kept warm.  The use of hearts donated after circulatory death would make far more available for transplant.  This breakthrough represents a major inroad to reducing the shortage of donor organs.

Michelle Gribilas, the first patient to receive one of the three hearts, said she was very sick before her operation.

“Now I’m a different person altogether,” the 57-year-old said. “I feel like I’m 40 years old. I’m very lucky.”

The second recipient, Jan Damen, who had the surgery about two weeks ago, said he felt “amazing”.

The team state that reanimating hearts using this novel preservation technique could increase safety for patients because it gave surgeons confidence that the organ was functioning and suggest that in the next five years or so they will be shifting more and more towards machine preservation of hearts.

Until now, Transplant Units have solely relied on donor hearts from brain-dead patients whose hearts are still beating. The new technique now allows doctors to transplant hearts that have stopped beating.

This represents a paradigm shift in organ donation and will result in a major increase in the pool of hearts available for transplantation.

Source:  Agence France-Presse (AFP)