THE world’s first “dead heart” transplants have been carried out in Australia.
Surgeons at St Vincent’s Hospital in Sydney performed the transplants using donor hearts that had stopped beating – and say they hope their success will widen the donor pool.
The surgery has been described as the biggest heart transplant breakthrough in a decade and the successful procedure has profound implications for reducing the shortage of donor organs, the director of St Vincent’s heart-lung transplant unit, Professor Peter MacDonald, said yesterday.
Previously, transplant units relied solely on donor hearts from brain-dead patients whose hearts were still beating.
But the Australian clinic has recently transplanted two hearts which were donated after circulatory death (DCD), where the heart is no longer beating. In both cases, the patients are recovering well.
The first person to have the procedure was Australian woman Michelle Gribilar. The 57-year-old was suffering from congenital heart failure and had surgery about two months ago.
Ms Gribilar said, prior to the operation, she had not been able to walk 100m without trouble. Now she walks 3km and climbs 100-120 stairs every day.
She said: “I was very sick before I had it. Now I’m a different person altogether.”
Jan Damen, 44, has also undergone the treatment.
The transplants of DCD hearts come as the result of combined research between the Victor Chang Cardiac Research Institute and St Vincent’s Hospital.
The New South Wales clinics created a special preservation solution which works in conjunction with a “heart in a box” machine, known as the ex vivo organ care system (OCS).
Professor MacDonald said the move to recover hearts which were previously considered unsuitable for transplantation means thousands more organs could become available to “end-stage” heart-failure sufferers.
He added: “In all our years, our biggest hindrance has been the limited availability of organ donors.”
Researchers are still determining how long after circulatory death a heart can be resuscitated, but have revived hearts more than 30 minutes after death.
The OCS allows the donor heart to be connected to a sterile circuit which restores the heartbeat and keeps it warm, limiting adverse affects associated with previous methods that saw hearts kept on ice.
Cold ischaemia, where the heart is dormant without oxygen or nutrients, occurs under traditional methods where the organs are kept on ice.
But using the preservative solution and the heart in a box, the heart is able to be reanimated, preserved and assessed until it is ready to be transplanted.
Cardiothoracic surgeon Prof Kumud Dhital, who performed the transplants with hearts donated after circulatory death, said he “kicked the air” when the first surgery was successful.
Between 2013 and 2014 there were 206 heart, and heart and lung, transplants in the UK.
Maureen Talbot, senior cardiac nurse at the British Heart Foundation, said: “This is a significant development that will hopefully increase the number of donor hearts available for transplant in the future.”