Heart Transplant first5th June 2006
A 58-year-old man has become the first Briton to receive a 'beating heart', due to a device that keeps donated organs alive outside the body. The patient is said to be recovering well at the Papworth Hospital in Cambridge after becoming only the fourth person in the world to get a heart courtesy of the machine.
The Organ Care System keeps donor hearts functioning while they are transported in a sterile chamber to recipients. The heart is connected at the aorta, the pulmonary artery and the left atrium, which allows it to be fed with oxygenated and nutrient-rich blood from the donor kept at body temperature. The system is able to keep a heart alive for up to 12 hours and may in future allow the pumping of drugs into the organ.
Currently donated hearts are normally given a high dose of potassium to stop them beating and are packed in ice which helps to keep them in a state of "suspended animation"; they deteriorate rapidly, giving surgeons only around four hours between their removal from donors and their implantation in recipients. Hearts stored using the cold ischemic storage, which has remained virtually unchanged for more than 25 years, have no blood circulation.
The managing director of UK Transplant - which coordinates the matching of donated organs and recipients - Chris Rudge, said that this system could prolong the time that one can store the heart before the transplant. He added that the reason that people are extremely interested in this system is it allows the heart to be manipulated with drugs; "You could potentially make the heart work better than the way it worked before it was removed from the donor, and therefore hearts that are not currently considered for transplants might become useable." he said.
Professor Bruce Rosengard, who led the team carrying out the transplant, said the technique could raise the number of potential donors by at least 50%.
Last year 149 patients had heart transplant operations in Britain. Eighty-five per cent of transplanted hearts are still functioning after a year, and around 70 per cent after five years. Demand for donor organs is increasing, but more than half of all hearts for which consent for donation has been given go unused, partly because of the limits of cold preservation methods. Some healthy donor organs go unused because there are no matched recipients within a close enough range to receive it in time.
Researchers have completed pre-clinical trials of the Organ Care System, carrying out transplants on pigs. They have now started a human clinical trial which will involve 20 patients at the Papworth Hospital, Harefield Hospital, in Middlesex, and at two German centres.
Prof Reiner Körfer, of Bad Oeynhausen Clinic for Thorax and Cardiovascular Surgery in Germany, said: "The benefits of warm versus currently utilised cold storage in preventing cell death and ensuring healthier organs have long been understood. This is the first system to make warm storage a reality."
TransMedics, the US company that developed the technology, is already working on applying the same technology to lung and liver transplantation.
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Title: Heart Transplant first
Author: Sue Knights
Article Id: 387
Date Added: 5th Jun 2006