- American doctors successfully reanimate a heart after its donor died
- The technique pumps the donor heart with blood, oxygen, and electrolytes
- Duke University is the first US hospital to complete the procedure
For the first time in the United States, doctors have successfully reanimated and transplanted a dead donor heart. The team at Duke University Medical Center, composed of Drs. Jacob Schroeder, Benjamin Bryner, and Carmelo Milano, performed the procedure known as donation after circulatory death (DCD). Traditionally, the human heart is obtained from donors who are declared brain dead but with other vital organs still functioning.
However, in this innovative procedure, Dr. Schroder described that the heart stopped beating and blood circulation in the donor’s body stopped. A five-minute “hands-off period” then followed, wherein the patient’s death was announced. The heart was then perfused with a cold solution and then removed. After this step, the heart was placed into the TransMedics Organ Care System, a warm perfusion pump where the heart was mechanically transfused with warm blood, oxygen, and electrolytes and consequently beat again. The heart was kept in the system until it was ready for transplant. Standard heart transplant protocol followed the procedure.
Called “Heart in a Box”, the TransMedics Organ Care System pumps blood, oxygen, and electrolytes to the heart.
The procedure has been previously done at the Royal Papworth Hospital in the United Kingdom in 2015, where demand for donor heart is higher. However, the case is groundbreaking in the United States as it is the first to be performed on an adult.
This first-of-its-kind procedure in the US is an exciting development that could increase the donor pool in the country. In the US alone, the waitlist for transplant is over 100,000 people long. According to Dr. Schroder, donation after circulatory death transplants can increase the donor pool and transplants by 30%.
In the United States alone, the need for organ transplantation is high, with the waitlist over 100,000 people long.
Although the procedure is a major positive breakthrough, like any other medical procedure, it does come with significant risks. According to Dr. Ashish Shah, chair of cardiac surgery at Vanderbilt University Medical Center, the period of time when the heart has no oxygen or blood prior to the machine’s perfusion is crucial.
“This period can vary considerably and may injure the heart permanently. That injury may not be seen until later, but it’s the one worry about using these organs”, Dr. Shah stated.
In addition, the procedure must be done in facilities where doctors can strictly control and monitor the timing of the procedure. Nevertheless, Dr. Shah has also expressed hope that the US will be able to replicate the success of Australia and other European countries in DCD.
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