The Future of Heart Transplants: Beating Hearts

A Los Angeles heart transplant patient has recently received a "beating heart" in a transplant procedure being tested in which the donated heart is kept oxygenated while awaiting transplantation. In conventional heart transplants, the heart is injected with a chemical for preservation and kept frozen in an ice chest immediately after donation. This puts the heart in a suspended state; however, damage is still very possible under this old method, and doctors must quickly transplant the donor organ into the transplant recipient. Generally, the transplant heart is only good for 4 to 6 hours after donation. This means that geographic considerations must be taken into account, and it is extremely difficult to transport these hearts long distances within an appropriate time. This time factor also means that surgical transplant teams must often be prepared very quickly and transplants are often performed in the early hours of the morning.

In the transplant method being tested, the heart is not kept frozen after donation. Rather, it is kept in a Organ Care System (OCS) developed by TransMedics Inc. The beating heart box keeps the heart at "near physiologic beating state" and supplies the heart with warm, oxygenated blood supplemented with nutrients and electrolytes. Researchers suspect that this new method will reduce damage on transplanted hearts. Once the OCS is hooked up, which takes roughly 20 minutes, any deterioration on the heart is fully reversed. Furthermore, the heart can be kept within the beating heart box nearly indefinitely, so time is not an especially important factor with this procedure. The tested system would give doctors more time to prepare for transplantation as well as the ability to examine the transplant heart before insertion. Dr. Bruce Rosengard, the doctor who performed the first beating heart transplant, says that the new system takes the rush factor away. So far, around 100 people have received hearts using this new method, and results look encouraging with a survival rate of 97% after one month and a low incidence of organ rejection and other complications. The success of this new procedure will depend both on its effectiveness compared to the current system, and its price.

This was interesting to me because I am planning on one day working as a cardiologist. This new procedure, if implemented, could certainly become an important part of my job. Besides job aspects, this was also interesting to me because of my family's history of heart problems. Perhaps one day this new procedure will be used for a heart transplant to one of my family members or even myself. If proven effective, this new procedure will almost certainly play into my future as a doctor and possibly even as a patient.

Link:
Medical News Today: Los Angeles Transplant Patient Receives "Beating Heart"