‘Dead heart’ transplant breakthrough at St Vincent’s Hospital | The Australian


  2. OCTOBER 24, 2014 3:16PM

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John Ross

Higher Education Reporter


A SYDNEY surgeon has successfully transplanted “dead” hearts into three patients, in a breakthrough that could dramatically boost the survival prospects of people with serious heart disease.

St Vincent’s Hospital’s Kumud Dhital has successfully used hearts that had stopped beating, in operations performed over the past few months.

The most recent was on Wednesday night.

Two patients, 57-year-old Sydney woman Michelle Gribilas and Sydney man Jan Damen, 40, fronted the media today, demonstrating their recovery from the groundbreaking procedure.

Researchers from St Vincent’s and the Victor Chang Cardiac Research Institute have managed to resuscitate hearts that had stopped beating more than half an hour earlier.

St Vincent’s said that until now, transplant units had relied solely on donor hearts from brain-dead patients whose hearts were still beating.

It said the use of hearts donated “after circulatory death” represented a “paradigm shift” in organ donation, heralding a major increase in the pool of available hearts.

Peter MacDonald, head of St Vincent’s Heart Transplant Unit, said it was a “timely breakthrough” three decades after the unit’s establishment.

“In all our years, our biggest hindrance has been the limited availability of donor organs,” Professor MacDonald said.

Dr Dhital said dead hearts had been used in the first wave of human heart transplants in the 1960s, with the donor and recipient in adjacent operating theatres.

“This co-location of donor and recipient is extremely rare in the current era, leading us to rely solely on brain-dead donors – until now.”.

The technique used a special preservation solution that works in conjunction with a “heart in a box” machine, known as the ex vivo organ care system.

Associate Professor Dhital told media today he “kicked the air” when the first surgery was successful. It was possible thanks to new technology, he said.

“The incredible development of the preservation solution with this technology of being able to preserve the heart, resuscitate it and to assess the function of the heart has made this possible,” he said.

The first patient to have the surgery done was Ms Gribilas, who was suffering from congenital heart failure and had surgery about two months ago.

“I was very sick before I had it,” she said. “Now I’m a different person altogether. I feel like I’m 40 years old. I’m very lucky.”

The second patient, Mr Damen, also suffered from congenital heart failure and had surgery about a fortnight ago.

The father of three is still recovering at the hospital.

“I feel amazing,” he said. “I have to say I never thought I’d feel so privileged to wear the St Vincent’s pyjamas.

“I’m just looking forward to getting back out into the real world.”

The former carpenter said he often thinks about his donor.

“I do think about it, because without the donor I might not be here,” he said. “I’m not religious or spiritual but it’s a wild thing to get your head around.”

Professor MacDonald said the team had been working on this project for 20 years and intensively for the past four.

“We’ve been researching to see how long the heart can sustain this period in which it has stopped beating,” he said.

“We then developed a technique for reactivating the heart in a so-called heart in a box machine.

“To do that we removed blood from the donor to prime the machine and then we take the heart out, connect it to the machine, warm it up and then it starts to beat.”

The donor hearts were each housed in this machine for about four hours before transplantation, he said.

“Based on the performance of the heart on the machine we can then tell quite reliably whether this heart will work if we then go and transplant it.”

Additional reporting: AAP

via ‘Dead heart’ transplant breakthrough at St Vincent’s Hospital | The Australian.

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