Doctors perform world's first transplant using a 'dead' heart
Alok Jha
Former Science Correspondent
The doctors at the St Vincent’s Hospital heart lung transplant unit in Sydney announced something remarkable this morning - the successful transplant of hearts that had stopped beating.
Two patients with congenital heart failure, Michelle Gribilas and Jan Damen, had the surgery a few months ago and had recovered well enough to speak at a press conference in Sydney this morning. A third patient is still recovering in intensive care.
In a normal heart transplant, the donor heart is taken from someone who has suffered brain death - the heart is still beating and is kept beating by surgeons until the moment it is removed and taken to a waiting patient.
In the cases in Sydney, the donors had died of circulatory death and the hearts had already stopped beating inside them. As soon as this happened, the hearts will have started to degrade - the surgeons in Sydney removed the organs from the donors and installed them into a rig (nick-named the “heart in a box”) that kept the hearts warm, while nutrients and fluids circulated through them. This seems to have re-started the hearts and also helped to reduce damage, keeping them in good condition for transplant.
The full details of the procedure are not yet clear and, for scientists and doctors to replicate it elsewhere, the team in Sydney will have to publish their results in detail in a peer-reviewed medical journal. Only then can surgeons elsewhere examine the process, work out how to use it where they are and, crucially, iron out problems.
The implications of the technology are clear if it becomes widespread - if it can be made to work in a wider number of cases, it will significantly increase the number of hearts available to surgeons for transplantation purposes. Often, heart donations have to be rejected because they are not in good enough condition or they are too far from the intended recipient - the “heart in a box” approach could keep hearts in good condition for longer.
According to the British Heart Foundation (BHF), last year there were 145 heart and three heart and lung transplants at seven hospitals around the UK. There are around 275 people on the waiting list. Maureen Talbot, a senior cardiac nurse at the BHF, said of the Sydney announcement:
James Neuberger, associate medical director for organ donation and transplantation at NHS Blood and Transplant, said he welcomed any development that made more organs transplantable and more widely available. “This single case is encouraging and should be seen in the context of other developments for maximising the use of hearts and other donated organs,” he said.