There is hope for transplant patients, from technology that can keep a heart alive for 24 hours.
At the moment, a donated heart can usually only last about four hours as it is precipitated to the person who needs it.
But by pumping fluid through its blood vessels and using oxygen pulses that mimic a heart beat, scientists were able to keep the pigs’ heart for 24 hours.
They say the technology could be available to human hearts in a year.
The turning point, using a device that fits into a small suitcase, could cut the waiting lists for transplants.
How the pioneering device would work, keeping the organs oxygenated and alive for 24 hours
There is hope for transplant patients, from technology that can keep a heart alive for 24 hours
The latest figures show that in the UK there are 328 people waiting for a heart, including 39 children.
Many are forced to wait until it’s too late, and the figures suggest that around three quarters of the donated hearts cannot be used in the UK.
Dr Rafael Veraza, of the University of Texas Health in San Antonio, presented the results on pig hearts, which still looked oxygenated with viable cells after 24 hours, during the annual meeting of the American Association for the Advancement of Science in Seattle.
He said: ‘The first heart was transported over 50 years ago by putting it on ice and decades later it was done the same way.
“But being able to maintain a viable heart for 24 hours means that you could carry it almost anywhere in the world, and this could save many lives.”
While the main reason why hearts are not taken from UK donors is because they are unsuitable, experts say the time between organ removal and transplantation is “crucial”.
Heart transplants: the facts
A heart transplant is an operation to replace a damaged or diseased heart with a healthy heart from a recently deceased donor.
It can be recommended when a person’s life is at risk because his heart is no longer functioning effectively.
Why heart transplants are performed
A heart transplant can be considered in case of severe heart failure and medical treatments don’t help.
Conditions that may possibly require a heart transplant include:
- coronary heart disease – an accumulation of fatty substances in the arteries that supply the heart, which block or stop blood flow to the heart
- cardiomyopathy – where the walls of the heart have stretched, thickened or stiff
- congenital heart disease – birth defects that affect the normal functioning of the heart
If your doctor thinks you could benefit from a heart transplant, you will need to have a thorough evaluation to see if you are healthy enough to have one before being placed on a waiting list.
What happens during a heart transplant?
A heart transplant should be performed as soon as possible after a donor heart becomes available.
The procedure is performed under general anesthesia, where you sleep.
As it is performed, a heart lung bypass machine will be used to keep the blood circulating with oxygen-rich blood.
A cut is made in the middle of the chest. Your heart is then removed and the donor heart is connected to the main arteries and veins. The new heart should then start beating normally.
Outlook for heart transplants
Most people can eventually return to their normal activities after a heart transplant and experience significant improvement in symptoms for many years.
But it’s an important operation and some of the complications can be life-threatening.
- 80 to 90 people out of 100 will live at least one year
- 70-75 out of 100 people will live at least 5 years
- 50 people out of 100 will live at least 10 years
Some people have survived for over 25 years after a heart transplant.
The average person waits nearly three years – 1,085 days – for a heart transplant, with NHS Blood and Transplant reporting in 2018 that a man, 45-year-old Gareth Evans of Stockport, had been on the waiting list for nine years.
The key to preserving hearts for an entire day is to imitate the conditions of the human body as much as possible.
This means rinsing a storage solution through the arteries, delivering 60 pulses of oxygen per minute like a heart beat and suspending the heart in a solution, similarly to how it is found in the body, to prevent it from collapsing under its own pressure.
U.S. researchers tested their system, called ULiSSES, in five pig hearts, finding that they appeared viable after 24 hours, with little of the swelling indicating cell death.
The next step is to transplant hearts into pigs, to ensure their proper functioning, before moving on to human hearts.
The researchers plan to test donated hearts that are unsuitable for transplantation within three months and are already discussing them with hospitals.
If the necessary official authorizations are granted, scientists say that hearts kept for 24 hours could be given to people within a year.
They also hope to use technology to preserve and transport the limbs lost in the war, road accidents or industrial accidents, so these could be reattached, although so far it has only been done using pig limbs.
The researchers claim to have a U.S. government scholarship to research this.
Hearts are currently stored at 4 ° C (39 ° F), but hopefully in the future they will be kept at room temperature, eliminating the need to transport organs on ice.
Donor hearts, stored in this way, previously seemed to function normally for a short time in dogs.
Dr Veraza, a postdoctoral researcher at UT Health, said: “The important thing about our research is how portable this device is.
“We hope it will make more organs available, which can be kept of good quality, so that there are more lots and less waste.”
The waiting list for a heart transplant more than doubled from 126 people in March 2010 to 295 in March last year.
John Forsythe, medical director for organ donation and transplantation at NHS Blood and Transplant, said: “For a heart transplant to succeed, the time between recovery and transplantation is particularly crucial.
“The use of machines to stabilize and preserve organs is an important area of development and the use of oxygen” perfusion “techniques has proven extremely effective in other organs, including the liver and pancreas.
“UK teams are exploring the use of similar techniques for heart transplantation, through our world-leading DCD cardiac program (death after circulatory death) – and are also examining how machines and techniques have pioneered as part of this program, they could also be applied to hearts transplanted after the death of the brain stem.
“We welcome any research based on this.”
The 34-year-old who was waiting for a three-year list for a heart transplant
The 34-year-old from Wirral has a number of heart conditions
Lyndsey Fitzpatrick tries to be optimistic, despite having waited nearly three years for a heart transplant.
The 34-year-old from Wirral has a number of heart conditions, which meant she needed three-year open heart surgery and a 10-year-old pacemaker.
He continued to have three other pacemakers.
In 2015 her health started to deteriorate and in September 2016 she entered the waiting list for a heart transplant.
He said: ‘I have had health problems all my life. All my life I have struggled daily with my mobility, shortness of breath and tiredness. I have to use a wheelchair or scooter for the disabled when I’m out and about.
‘I try to maintain a happy, cheerful and optimistic state of mind for everything and enjoy life even if I have to take life at a slower pace and rest when necessary.
“People tell me” You look good, “but I definitely don’t feel well, whatever it is. I guess I just got good at hiding my illness outside, but I struggle with it on a daily basis.”
Ms. Fitzpatrick added: “From an early age, my family and I knew that I would need a heart transplant, but now almost three years after joining the transplant list, I am still waiting for all these important calls.
‘A call to say that a game has been found for me, a call to say that I can start the next chapter of my life.
‘I know it’s difficult for people to talk about organ donation, but for people like me and many others who are waiting for a heart so that the conversation can save our lives.
“We kindly ask families to talk about organ donation and decide if it’s something they can agree on.”