World’s First Dead Heart Transplant at Sydney’s
St Vincent’s Hospital
· Sydney surgeon’s dead heart transplant a huge medical breakthrough
· Previously, transplants relied on donor hearts from brain dead patients
· Ability to revive hearts has major implications for donor shortages
· Two successful transplants performed in last two months
A doctor holds in his hands a diseased heart which had just been removed
from a patient during a heart transplant operation at the Cleveland Clinic in Cleveland.
(Photo: Jamie-Andrea Yanak, You)
In a world first, surgeons at St Vincent’s Hospital have made a dead heart beat again and successfully used it in a transplant. Described as the biggest heart transplant breakthrough in a decade, the successful surgery has profound implications for reducing the shortage of donor organs, the director of St Vincent’s Hospital Heart Lung Transplant Unit, Professor Peter MacDonald, said today.
Doctors at St Vincent’s Hospital in Sydney used a heart-resuscitation
console and preservation solution developed in Australia
to transplant dead hearts into patients
The doctors were able to preserve and resuscitate the organs used in the three procedures with the help of a so-called “heart in a box” machine.
The portable device, developed by Andover, Massachusetts-based TransMedics, revives a no-longer-beating heart while warming it and perfusing it with oxygenated, nutrient-rich blood. During this process, the organ is injected with a preservation solution that helps keep heart cells from dying to ensure that the organ survives surgery.
“Both the preservation solution and the console that allows the heart to be kept warm and beating and have blood going through it and getting oxygen,” Dr. Bob Graham, executive director at the Victor Chang Cardiac Research Institute, which developed the preservation solution, told ABC News in Australia. “Both of them are extremely important and I think if either had come alone, we would have a slight improvement but we wouldn’t have been able to do what we’ve done.”
And the patients certainly seemed pleased.
“I didn’t know how big [of a deal] it was,” Jan Damen, the second patient to undergo the procedure, told the Herald. “Having a heart is good but all the rest of it is, wow, who would have thought.”
For more on the “heart in a box” machine, check out this video from the University of California, Los Angeles below. It was posted to YouTube in 2011 when the university participated in clinical studies of the organ-preservation system.
Previously transplant units relied solely on donor hearts from brain dead patients whose hearts were still beating. But the 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.
Ms Gribilas (centre) said she is a ‘different person altogether’ after receiving her transplant
The first person to have the procedure done was Michelle Gribilar. The 57-year-old from Campsie was suffering from congenital heart failure and had surgery about two months ago. She is recovering well, saying today she “feels like she is 40” since the transplant. 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. “I’m a different person altogether,” she said. “I was very sick before I had it. Now I’m a different person altogether.”
The second patient, Jan Damen, 40, from North Narrabeen also suffered from congenital heart failure and had surgery about a fortnight ago. He is still recovering at the hospital. “I feel amazing,” the father of three said. “I have to say I never thought I’d feel so privileged to wear the St Vincent’s pyjamas. “I’m just looking forward to getting back out into the real world.”
The former carpenter said he often thinks about his donor. “I do think about it, because without the donor I might not be here,” he said. “I’m not religious or spiritual but it’s a wild thing to get your head around.” The transplants of DCD hearts comes as the result of combined research between the Victor Chang Cardiac Research Institute and St Vincent’s Hospital.
CUTTING-EDGE CANCER TREATMENT AND RESEARCH CENTRE OPENS SURVIVOR LEADS CAMPAIGN TO SUPPORT PINK RIBBON DAY
The two 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).
Dr Dhital, Ms Gribilas, NSW Health Minister Jillian Skinner, Mr Damen and
Prof Peter MacDonald at St Vincent’s Hospital on Friday
The OCS allows the donor heart to be connected to a sterile circuit which restores the heart beat and keeps it warm, limiting the adverse affects associated with previous methods which saw hearts kept on ice.
Cold ischaemia, where the heart is dormant without oxygen or nutrients occurs under traditional methods where hearts are kept in an Esky 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 go into a recipient.
Cardiothoracic surgeon Assoc Prof Kumud Dhital, who performed the transplants with hearts donated after circulatory death (DCD), said he “kicked the air” when the first surgery was successful. It was possible thanks to new technology, he said. “The incredible development of the preservation solution with this technology of being able to preserve the heart, resuscitate it and to assess the function of the heart has made this possible,” he said.
Medical staff transporting a heart in a heart-resuscitation console developed by doctors
at St Vincent’s Hospital and researchers at the Victor Chang Cardiac Research Institute
Professor MacDonald said the move to recover hearts which were previously considered unsuitable for transplantation means that thousands more hearts could become available to end-stage heart failure sufferers as the technology becomes more readily available. “In all our years, our biggest hindrance has been the limited availability of organ donors,” Prof acDonald said. Researchers are still determining how long after DCD a heart can be resuscitated, but have revived hearts more than 30 minutes after death.