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Doctors at St. Vincent’s Hospital in Sydney, Australia have accomplished something incredible. Using a new preservation method, three hearts were successfully transplanted from dead individuals to others in need, saving their lives. The successful operation was a joint effort between the Victor Chang Cardiac Research Institute and Sydney’s St. Vincent’s Hospital, with Professor Bob Graham leading the team.

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The transplanted hearts had stopped beating for over 20 minutes and were successfully transplanted into the bodies of 3 Australian patients for the first time, according to BBC report.

Previously, the typical method of transplant was to remove the heart from a donor patient, who is brain-dead but still has cardiovascular function, which means, donor hearts can only be harvested after brain death occurs, but while the heart is still beating. But today, the doctors at St. Vincent’s Hospital in Sydney claimed that they achieved the 3 heart transplants using hearts that had stopped beating for over 20 minutes. The hospital believes that up to 30% more lives can be saved through this new preservation method.

The Guardian reported that two of the patients have recovered well, while the third, who only undertook the procedure recently, remains in intensive care.

The Patient’s Perspective

Michelle Gribilas was the first patient to have the surgery, and described herself as a ‘different person altogether’ after receiving the transplant. Gribilas is a 57-year-old woman, who was suffering from congenital heart failure and had surgery for it two months ago. She said:

“I had the transplant a couple of months ago and I was very sick before I had it. Now I feel wonderful. I walk three kilometres a day.”

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Jan Damen, another patient, also talked about his experience. He is a carpenter, a husband and a father of three girls. He said:

“I feel amazing. 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.”

Ms Gribilas (centre).

Ms. Gribilas (centre).

How The Transplant Works?

There are many factors that need to be aligned in order to successfully transplant the heart:

1. The donor’s heart is kept alive and beating by a life support machine known as a “heart-in-a-box.”

2. The heart is preserved inside of the machine, minimizing the risk of damage to the heart. The machine makes it more flexible for transplantation and preserves it from a lack of oxygen.

3. When the preserved heart is warm enough inside the machine and once the beneficial patient is ready, the doctors disconnect the warm heart from the machine, and place it in the patient.

The Doctors Opinions

The director of the Hospital’s Heart Lung Transplant Unit, Peter MacDonald, told WebMD:

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

The Daily Mail reported that the new preservation method enabled transplants using hearts from 90-95% brain dead patients. In a previous time, this was not possible, because the heart gradually stops beating over about 20 minutes. The Daily Mail added:

“Under Australian law, surgeons must wait until there has been no heartbeat for five minutes before the organ can be removed. The lack of oxygen during this time causes significant damage to the heart and until now has meant those hearts could not be used for transplants.

But when the new solution is injected into the heart its cells start to regenerate.”

Professor Bob Graham was the leader the team, and has spent the last 12 years developing a specialized fluid and pump that provide the heart with oxygen, reducing damage and preserving the tissue.

Dr Dhital, Ms Gribilas, NSW Health Minister Jillian Skinner, Mr Damen and Prof Peter MacDonald at St Vincent's Hospital.

Dr Dhital, Ms Gribilas, NSW Health Minister Jillian Skinner, Mr Damen and Prof Peter MacDonald at St Vincent’s Hospital.

Kumud Dhital is another cardiothoracic surgeon who performed the transplants using hearts donated after circulatory death. He said this in a press conference:

“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.”

Dr Paul Jansz is also one of the surgeons who performed the transplants. He told Daily Mail Australia that the technology was approved within the last year and since then three patients have successfully received transplants, he added:

“North America and Europe are very envious that we were able to get on and do this. Many prestigious units around the world have been working towards this and haven’t been able to pull it off. It literally is a world first, it means a lot for the transplant world.”

The doctors believe that one day we will significantly increase the number of hearts available for transplant. The new developed technique could be easier on the heart than the ones used before, because it reduces the number of heart cells that die during the transplant process, and limits the amount of damage caused by a lack of oxygen.

Sources:

(1) The Guardian

(2) BBC

(3) Daily Mail


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