MOVING OUT OF THE COLD: SURGEONS REANIMATE HEARTS FOR TRANSPLANT

TransMedics Device Leads The Way As Transplant Medicine Swaps Cold For Warm

TransMedics’ “heart in a box” is allowing surgeons to “reanimate” hearts from recently deceased patients, and then transplant them to save lives. The Organ Care System, which consists of a wheeled cart with an oxygen supply, a sterile chamber and tubing, has been used successfully in the UK and Australia to facilitate transplants. Normally, donor organs are only taken from people who are brain-dead, but now can use organs from circulatory-death donors. The USD$250,000 (€225,000) device from Massachusetts-based Transmedics, could increase the number of hearts ready for transplant by between 15 and 30 percent, and save many lives in the future. In the US there are approximately 2,400 heart transplants each year, a figure that hasn’t really changed for the last 20 years.

In three documented cases, surgeons waited as little as two minutes after a patient’s heart stopped beating before they began to extract it. A short time later, they had the heart rigged up to the TransMedics machine, where once again it began to beat after it was pumped with oxygenated blood. Previously, the school of thought was that organs should be preserved in cold conditions which lower the metabolic rate of the tissue by almost 90 percent. But, now scientists say keeping the organ functioning and warm is a probably a better solution. According to Korkut Uygun, a transplant surgeon at the Massachusetts General Hospital, “Warm is the way to go with metabolically active tissue.” He believes the TransMedics device is too expensive and isn’t sufficiently automated. “In the short term they’ll open the field.” Other medical device companies will follow suit and prices will come down.