World first: Australian doctors transplant heart that had stopped beating

By David Mark-The World Today
Published on October 24, 2014

For the first time, Australian doctors have transplanted a heart that had stopped beating in what they say is a paradigm shift for organ donation.

Victor Chang Institute executive director Professor Bob Graham said a newly developed technique would save 20 to 30 per cent more lives.

The doctors at Sydney’s St Vincent’s Hospital transplanted a heart that had stopped beating for twenty minutes.

The heart was resuscitated with a new console and injected with a preservation solution that was developed by researchers at the hospital and the Victor Chang Cardiac Research after 12 years of work.

Professor Graham told the ABC’s The World Today program that most hearts were donated by patients who were brain dead but kept alive using a ventilator, which meant their hearts were still beating when they were transplanted.

But the new technique means more hearts can now be used for transplantation.

The first person to have the surgery was Michelle Gribilas. She is 57 and had suffered from congenital heart failure. She had the surgery more than two months ago and is feeling well.

Victims who suffer 90 to 95 per cent loss of brain function generally suffer kidney, liver and cardiac failure over a number of hours to days, Professor Graham said.

“What happens is we have a patient whose brain is almost completely gone, but they still have a little bit of brain function so they can’t be classified as being dead,” he said.

“And if the relatives agree we can turn off the life support. And when we do that the heart gradually stops beating over about fifteen minutes. We then by law have to wait another five minutes to make sure the heart has really stopped.

“Then we can take the heart out and we can put it on a console where we connect it up with blood going through the heart and providing oxygen.

“Gradually the heart starts beating again. And we also give it a preservation solution that allows it to be more resistant

to the damage of lack of oxygen.”

Professor Graham said the new preservation solution reduced damage to the hearts, made them more resilient for transplantation and improved the hearts’ function when they restarted.

“So those two things coming together [the console and preservation solution] almost like a perfect storm, have allowed this sort of transplantation of a heart that’s stopped beating to occur,” Professor Graham said.

“Before that it wasn’t possible.”

Professor Graham said the first transplant went to a 57-year-old Sydney woman, Michelle Gribilas, about three months ago.

“The first heart transplant that we did looked very, very poor indeed,” he said. “It wasn’t beating very well at all.

“By the time they brought the heart to St Vincent’s hospital from where the donor patient had been, the heart was starting to look a lot better.

“And by the time they put it into the patient it was looking very good.

“Several weeks after the transplant, they did a biopsy of the heart and they did an echocardiogram to look at the function of the heart and they were all virtually completely normal.

“There was no evidence of tissue damage.”
The team have since done another transplant using the method on a 44-year-old father of three, Jan Damen.

Professor Graham said the technique would open up the option for heart transplants in many countries around the world where the definition of death is not brain death, but heart death.

“In those countries they can’t do heart transplantation. This will potentially open up heart transplantation in Japan, Vietnam and other places where the definition of death is heart death, not brain death,” he said.

Check out the ABC video here.

The World Today By David Mark – Fri 24 Oct 2014

This article was originally published here:
http://www.abc.net.au/news/2014-10-24/new-heart-transplant-technique-is-a-paradigm-shift/5838536