RACHEL BELLE

UW doctors test a device that keeps donor hearts beating, pumping blood outside of the body

Sep 28, 2015, 1:41 PM | Updated: Sep 29, 2015, 5:41 am

A donor heart is hooked up to the system, with donor blood being pumped through it. (UW image)...

A donor heart is hooked up to the system, with donor blood being pumped through it. (UW image)

(UW image)

Traditionally, heart surgeons readying for a transplant, prepare a heart the same way.

“Stop the heart in the donor, procure it, put it on ice, then put it in a cooler,” explained University of Washington assistant professor of surgery, Dr. Jason Smith.

“Bring it back as fast as possible and put it in. But that presents some serious challenges in terms of timing and the amount of time the heart can be out of the body,” he said.

Dr. Smith said a heart can usually only survive four to six hours on ice. Which is why Smith, and several other surgeons around the country, are trying out a new device by TransMedics that may extend the heart’s life to at least ten hours.

“We call it the Organ Care System for the heart,” Smith said. “It’s essentially a pump that allows us to pump blood into the coronary arteries of the donor heart and keep the heart awake and beating and warm and perfused throughout the transport. Which we think will better preserve the heart and also extend the amount of time that the heart can be out of the body.”

This would allow heart donations to come from farther away, which means more matches can be made and fewer healthy donor hearts will go to waste.

“We really have a crisis in terms of the number of patients being listed for transplantation and the number of organs available.”

Dr. Smith said about 2,500 heart transplants are done in the U.S. each year, but about four to 5,000 people need one.

“There’s no transplant center in Hawaii for hearts,” he said. “So all of the hearts from the donors in Hawaii don’t get utilized because it’s just too far to go by cold storage.”

Besides the essential time element, Dr. Smith said the system allows doctors to monitor a beating, functioning heart during transport.

“Once the heart’s been taken out of the donor, it goes in the ice and we rush back with it,” he said. “We don’t know anything about what’s happening to that heart until it’s sewn into the recipient and we hope it starts beating. Which it does most of the time.”

“With the Organ Care System, once the heart is on the system and stabilized, we can observe the heart continuously. It’s in a clean container so we can visually observe the function of the heart. We can draw blood samples to tell how the heart’s doing metabolically. We can measure the pressures that the heart is generating and see if the heart is struggling in any way.”

It also lets doctors hook up a heart that may not have been functioning well in a donor’s body and see if it improves it’s function outside of that environment. Dr. Smith said a heart has the capacity to fully improve after a few hours, if it’s not receiving negative signals from a brain-damaged body.

The UW Medicine team hasn’t had an opportunity to try out the system in a real situation, but they have trained with it. And Dr. Smith said it’s proven to be very effective in Europe.

“In Europe, the system has been utilized for a clinical transplant where the heart was on the system for 10 and a half hours. Which means a total out-of-body time of about 12 hours.”

Smith said this new system will really help get much-needed donor hearts to the Seattle region, since we are so isolated from the rest of the country.

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UW doctors test a device that keeps donor hearts beating, pumping blood outside of the body