by ANTONIO REGALADO
A donated heart beats outside the body while being supplied with blood and oxygen
A technology to keep organs alive outside the body is saving lives. And provoking ethical debates.
Transplant surgeons have started using a device that allows them to “reanimate” hearts from people who have recently died, and use the organs to save others.
The “heart in a box” is a wheeled cart with an oxygen supply, a sterile chamber, and tubing to clamp onto a donor heart and keep it fed with blood and nutrients. Doctors say it may extend the time a heart can last outside the body and is letting them recover hearts from donors who haven’t been eligible before.
In at least 15 cases, surgeons in the United Kingdom and Australia say they have used the system to successfully transplant hearts removed from patients after they’ve died. Typically, heart transplants only come from brain-dead donors whose hearts are cut away while their bodies are still healthy.
The $250,000 device was developed by Transmedics, an Andover, Massachusetts-based company, and is pending approval in the U.S. It could expand the number of donated hearts by between 15 percent and 30 percent, say doctors, saving the lives of people who would otherwise die from heart failure.
In the U.S. about 2,400 heart transplant occur each year, a figure that has remained essentially unchanged for 20 years.
Earlier this year, in the Lancet, surgeons at St. Vincent’s Hospital in New South Wales described three cases in which they waited as little as two minutes after a person’s heart stopped before they began removing it. Within 20 minutes, they’d attached it to the Transmedics rig, where it began beating again after being fed with oxygenated blood and electrolytes.
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