New 'Beating-Heart' Transplant Could Ease Organ Shortages

Two weeks ago in the United Kingdom, a man in his late 50s received a new heart -- a heart that was still beating while waiting to be transplanted.

The operation, at Papworth Hospital in Cambridge, England, was the first successful "beating-heart transplant" performed in the United Kingdom.

Instead of packing the heart on ice after removing it from the organ donor, this new technique keeps the heart warm and beating because it's attached to a specialized machine while it's transported to its new owner, who can be hundreds of miles away.

If approved for U.S. use, the beating-heart machine has the potential to help solve a chronic organ shortage crisis, experts say.

The device could "increase the pool of 'acceptable' donor hearts by allowing surgeons to transplant otherwise 'marginal' donor organs," said Dr. John Byrne, chairman of the Department of Cardiac Surgery at Vanderbilt University Medical Center.

By being attached to the device, a heart that may not normally be transplanted could be resuscitated because the heart would be pumping and having fresh blood flow through it.

As a result, the donor supply could increase, explained Dr. Barley Griffith, professor and chief of Cardiac Surgery at University of Maryland. The heart can also endure longer periods of time outside of the body when attached to the device.

In the United States, about 90,000 patients are currently waiting for an organ transplant -- 3,000 of whom are waiting for a new heart, according to Transmedics.

The Organ Care System perfuses "warm, oxygenated, nutrient-rich blood through the organ from the time of removal until it is implanted," according to Transmedics.

The transplant done on the man in the United Kingdom was part of a European trial, and about 20 more similar transplants are planned, the BBC reported.

The company hopes to progress into U.S. clinical studies at the end of the year, according to David Kolstad, a Transmedics marketing vice president.

Transmedics has "conducted initial human feasibility work with Dr. Robert Kormos at the University of Pittsburgh, and we continue to work closely with him and others in the U.S. on the design and development of the device," Kolstad said.

The first human heart to be supported on such a device was in 2001 at the University of Pittsburgh, led by Kormos, the former director of the Heart and Lung Transplant Program at the University of Pittsburgh.

Kormos and his team took a human heart from an 80-year-old donor and tested it on Transmedics' Organ Care System. This heart was kept beating for close to 12 hours while attached to the device.

"We were impressed at the ability of [the heart] to beat for extended periods of times and be well nourished [while attached to the device.] More importantly, [the heart] did not develop signs of swelling or organ damage, which were usually previously seen when preserving organs in a box," said Kormos, current director of the Artificial Heart Program and Medical Director at McCowan Institute for Regenerative Medicine.

Devices that are similar to Transmedics' Organ Care System could be used for other solid organs as well, such as livers and kidneys.

However, "the need is slightly less [than for hearts] since livers and kidneys are preserved for 24 hours with current techniques," said Dr. Bruce Reitz, the Norman Shumway professor in the Department of Cardiothoracic Surgery at Stanford University.

Meanwhile, the University of Maryland's Griffith and colleagues are working with a U.S. organ transplant company, Organ Recovery Systems, on a similar device for hearts. However, with their device, the heart does not beat but instead is kept nourished by a solution that flows through it.

"The key is whether the heart has a nutrient supply during preservation, not whether [the heart] beats," Griffith said.

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