Doctors from Duke University Medical Center have successfully ‘reanimated’ a heart in a groundbreaking transplant performed for the first time on an adult in the US.
Heart transplants usually come from donations after someone’s cause of death was brain-related and whose heart is still beating.
This method used by this team of doctors is called donation after circulatory death or DCD and it’s performed on hearts which have stopped beating and are reanimated to beat again before transferred into the recipient’s body.
Successful ‘Reanimation’ of a Dead Donor’s Heart
Thanks to the TransMedics Organ Care System, a warm perfusion pump, the doctors are able to revive and preserve hearts for transplant.
This system was used at the Duke Medical Center, one of the 5 centers in the US approved by the FDA for clinical trials of the TransMedics system.
The procedure was led by doctors Jacob Schroder, Benjamin Bryner, and Carmelo Milano from the Duke team.
According to Schroder, there have been pediatric donations after circulatory death transplants done in the past; however, this is the first performed on adults in the US.
However, in some Australian and UK centers, this procedure has been performed for several years. In fact, the UK Royal Papworth hospital has done 74 successful DCD transplants until now.
Dr. Pedro Catarino, director of transplantation at this hospital in the UK said that the need wasn’t desperate in the US as it was in the UK and he believes this is the main reason why there’s been a delay in the US to take up these donors.
However, he emphasizes that the US have a much higher rate of heart transplants- in 2018, they performed 10.5 transplants per million people in comparison to the UK with 2.9 transplants per million individuals.
What Happens During the DCD Transplant Procedure?
According to Schroder, the heart and the circulation stopped. They had a 5-minute hands-off period until the death of the patient was pronounced.
The doctors procured other organs which have also been identified for donation while the heart was perfused and then taken out.
During the procedure, the heart stays on the organ care system until the recipient is prepared for transplantation.
When everything is ready, the heart is placed back to ‘sleep’ and implanted with the right procedure.