Two Australian patients had hearts transplanted into their bodies – they had been dead for over 20 minutes. This became possible due to a new method of preservation. The capability to save hearts after they have stopped beating is a break through, which will stretch the amount of organs available, hopefully catering the needs 30% of those on the transplant wait list. The research was a team-effort by Victor Chang Cardiac Research Institute and Sydney’s St. Vincent’s Hospital, with Professor Bob Graham leading the team.
Usually, donor hearts get harvested only after brain death takes place, but the heart doesn’t stop beating. If the heart does not beat, it indicates lack of sufficient supply of oxygen. This lack of oxygen causes damage and death of cardiac cells, which does not make for an ideal transplant organ. Therefore, they need to harvest a functional heart, wrap it in ice, and implant it in the recipient inside four hours to ensure tissue quality. Whereas, kidneys and livers can be obtained following cardiac death, hearts have never been used.
In order to transplant a heart successfully, diverse factors need to come together all at once and this forbids many from obtaining life-saving organs, one of which is simple geography. An organ could be a perfect match for someone, but if they are a little too far away to meet that deadline, they cannot use it.
This new technique utilizes heart death, not just brain death, which expands the pool of who can donate a heart. For example, a person on life support probably have a very little amount of brain activity left with no chance of getting better, but in technical terms is not brain dead, thus is not a donor candidate. The patient’s family may opt to end life support, which will finally cause the heart to stop beating. Five minutes following end of cardiac activity, the patient may be declared dead.
Graham’s team after working for 12 years has developed a unique fluid and pump that supplies the heart with oxygen, reducing damage and preserving the tissue. The heart, that looks blue from lack of oxygen, starts to turn back to a normal pink color, eventually help revive the organ, making it beat again. Making it beat on the machine is a good sign that it will function after being transplanted into the recipient.
By letting the donor heart stay functional and fresh, it near about doubles the four-hour transplant window. This spares time for a perfect match to be found, which is one of the positive indicators that the surgery will be successful.
Two dead hearts have been revived with Graham’s machine – and have been implanted into two patients who both had heart failure. Michelle Gribilar, a 57-year-old woman from Sydney had it implanted two months ago, while Jan Damen received his heart about two weeks ago. Both of them are feeling great.
”Both of the patients, I’m pleased to say, are doing extremely well.” Graham said. Graham also pointed out that this procedure could also be employed to save lives in countries including Japan, where ”brain death” is not a legal definition of death, thus disallowing hearts from those patients to be used.