2023-04-29 18:20:35
For the first time, American surgeons have succeeded in transplanting a beating heart from a donor in a state of cardiac death. Already performed for six patients, the technique will increase the number of organs available.
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In the United States, the very first heart transplant took place in 1968 at Stanford Hospital. Since then, technical innovations have followed one another with the aim of improving the condition of the organs to be transplanted and thus increasing their availability. At Stanford Hospital, surgeons have just performed a feat on an organ from a donor in a state of cardiac death: the transplantation of a heart that was still beating. The technique has already been tested and successful on six patients, both adults and children. For the research team whose study is published in the Journal of Thoracic and Cardiovascular Surgery Techniquesit’s about pushing the limits of the possible.
What transplant options?
Many heart transplants are performed from brain-dead donors whose hearts are still functioning. The advantage is that it is easier to stabilize the organ, which only stops once. The heart is taken from the deceased donor and kept at low temperature before being transferred to the recipient. However, the demand for transplantation is still far greater than the supply, which forces the medical world to find other tricks.
A different approach is to perform heart transplants from donors who have died of “cardiac” or “circulatory death”, ie whose heart has already stopped once, either naturally or induced. Although this procedure increases the number of donors by 30 to 50%, the results for the recipients appear to be less good. Already because the heart is most often stopped a second time, just before the transplant. According to the authors of the study, this would harm the health of the organ by inducing more damage. In addition, organs removed in this way would suffer more oxygen deprivation, which would decrease the chances of survival after transplantation.
The “heart in a box” technique
The solution found by scientists porteporte the name “heart in a box”. Instead of being placed in ice, the organ removed from the donor is placed in an infusion machine with warm, oxygenated blood, which restores heart function without stopping its beating. ” Keeping the heart beating really does seem to make a difference in its strength, with less time spent on the heart-lung machine said Dr. John MacArthur, Assistant Professor of Cardiothoracic Surgery. This new way of transplanting is much faster (four hours for the first performed), allowing recipients to spend less time in the hospital.
In detail, the cardiopulmonary bypass machine pumps blood and oxygen throughout the body, and ensures uninterrupted circulation of warm blood. Then the surgeons proceed to the difficult stitching of the beating heart into the recipient.
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