Richard Jackson, 47, from Portage, PA, is now home and doing well after receiving his new heart on April 8. Heart transplants are exciting, but in this case, how the donor heart was maintained prior to surgery is extraordinary.
McGowan Institute faculty member Dr. Kenneth McCurry is the surgeon and the principal investigator of the trial evaluating TransMedics Inc.’s Organ Care System (OCS) for heart transplants. The OCS is designed to maintain donor hearts in a beating, functioning state during transportation from the donor to the recipient’s hospital. After removal from the donor, the heart is placed into the OCS, where it is immediately revived to a beating state, perfused with oxygen and nutrient-rich blood, and maintained at the appropriate temperature. Using the OCS, organs are kept in their physiological, beating state for delivery to the recipient and until implantation.
With donated organs, ischemia time, meaning the time the tissue is deprived of oxygen, is critical to the viability of the organ upon transplant. The current practice is to place a donated organ “on ice” for up to 4 hours without circulating blood and nutrient solutions and oxygen. The OCS provides those important inputs and keeps the heart warm while in transport, thus lessening ischemia time, and providing a healthier, better functioning organ for transplant. Total ischemia time with the OCS is estimated to be 45 minutes.
The FDA approved the OCS for clinical trials. To begin with, 20 patients will be enrolled from 5centers: Pittsburgh’s UPMC, Boston’s Brigham and Women’s Hospital, Los Angeles’ UCLA Medical Center, University of Chicago Hospitals Cardiac Center, and the Cleveland Clinic Heart and Vascular Institute. Two other UPMC patients have received heart transplants that involved the use of the OSC since Mr. Jackson’s transplant. The machine was used successfully for 20 heart transplants in Europe. TransMedics, Inc. plans to develop similar machines to extend preservation of other transplantable organs, such as lungs, kidneys, and livers.
An advantage of using the OCS is organs may be preserved for longer periods of time, thus changing the rules regarding organ allocation. Also, it might allow use of “marginal” organs that typically would not be candidates for transplant because they were too weak to survive on ice. The United Network for Organ Sharing reported on May 17, 2007, that almost 3,000 people were on the network’s waiting list for heart transplants.
Illustration: TransMedics, Inc.
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UPMC News Bureau (05/17/07)
Pittsburgh Post-Gazette (05/17/07)
Pittsburgh Business Times (05/17/07)
The Tribune-Democrat (05/17/07)
Pittsburgh Post-Gazette (05/18/07)
Pittsburgh Tribune-Review (05/18/07)
The Hindu (05/18/07)