Medical trial led by Royal Papworth in Cambridge could revolutionise heart transplant surgery
One of the world's leading transplant centres is carrying out a major trial which could revolutionise treatment for heart patients.
Instead of using ice to preserve organs used in heart transplant surgery, the trial is using a special transportation box.
Known as the XVIVO, the box contains a machine which keeps the heart supplied with oxygen and nutrients, protecting it ahead of surgery.
The trial - described as potentially one of the biggest changes to heart transplantation in more than 40 years - is being led by the Royal Papworth Hospital NHS Foundation Trust in Cambridge.
And a chartered surveyor from Northampton has become the first person in the UK to sign up to the new trial which is supported in the UK by the National Institute for Health and Care Research (NIHR).
Adrian is one of more than 200 participants globally to have been recruited to the trial across 15 international sites.
The 65-year-old keen cyclist, had been fit and well throughout his life until around 2004 when he began to experience breathlessness when exercising.
He said: “It was getting harder to get up certain hills. I didn't take any notice of it but then I started getting a cough and other issues, so my wife, Mary, encouraged me to go to my GP.”
He was diagnosed with cardiomyopathy, a type of heart disease which makes it harder for blood to be pumped around the body.
The next 15 years saw Adrian and his doctors manage with medication and a pacemaker before his condition deteriorated and he entered end-stage heart failure.
He underwent a heart transplant in December 2022 at Papworth.
In the time between being admitted and having his transplant, the trial opened to recruitment and Adrian was told about the research:
“I was given a leaflet, which I read through. I thought it would help one way or another, so I was quite happy to sign up and contribute something to this research.”
About the XVIVO trial
How the trial works
How the trial works
Before heart transplant, the donor heart must be protected. Traditionally, this is achieved by stopping the heart and placing the heart in a cold solution whilst it is being transported to the recipient. This is to protect the heart by reducing how much energy it uses.
This technique has been used since heart transplantation first started.
The new method, currently being trialled, protects the heart by connecting the cooled resting heart to a pump that provides the heart with a preservation solution that delivers oxygen and nutrients during transportation.
The aim of this study is to see whether transplant outcomes are better with the new method.
Patients will be randomised to either standard care or the new technique. In total, 202 patients are expected to participate in eight different countries.
In contrast to the standard method of transporting hearts on ice, the new technique connects the cooled heart to a pump that provides it with oxygen and nutrients during transportation for transplants.
Patients who sign up for the trial are randomised which means the heart has either been transported in the standard way or in the new way. It is not known which until the trial ends, but this did not deter Adrian from taking part:
“In fact, the first thing I said when I came off the anaesthetic was ‘I can breathe, breathing’s easy’, and it’s been working perfectly ever since!”
“If this process can help improve heart transplantation in the future, then we need to do these tests to find the proof. I'm very pleased to have done it and if it helps someone else's life, that's even better!”
Mr Marius Berman, Surgical Lead for Transplantation at Royal Papworth Hospital and Principal Investigator, said: “I am very grateful to Adrian and all of our patients who agreed to take part in this important multi-centre, international trial, which could fundamentally change the way we perform donation after brain stem death heart transplants."