The world of medicine had witnessed a series of advancements in organ transplantations but what happens in case the donor and the recipient are miles apart requiring long hours of organ shipment?
A new device designed by TransMedics, a US based bio-tech company, has made this possible most probably ending the conventional practice of organ transportation in the ice where the organ functioning can last for only few hours. The device is already in circulation in Europe, Canada and Australia and is awaiting approval in the US.
The heart can be safely placed in this device and transported to the recipient in a distant location prior transplantation. The human heart continues to function well as if inside a human body surrounded by the same ambient temperature. The device is capable of following up the heart’s health up-close.
Shortening the demand-supply gap:
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According to Cleveland Clinic estimates, of 3000 patients in the US waiting for heart transplants each year, only 2000 get the required heart transplants due to the limited availability of donors. With the availability of ‘Heart-box’ from TransMedics, the number of organ recipients is expected to grow by 15-20%.
Warming of the heart is the in-thing:
This miracle device employs a technology known as Ex Vivo warm perfusion that lets the donated organs like the heart to stay outside the human body for long with all its functional potential sustained.
Cold temperature helps preserve any organ by arresting the pace of metabolism and this explains why living organs can be preserved inside a freezer. When taken out of the body, warming of the organ starts and its condition rapidly deteriorates before a successful transplant can be made.
Hearts have a very small survival time of only 4-6 hours once taken out of the human body. However, it will be possible to sustain the heart life if nutrient rich oxygenated blood is kept pumping into the heart continuously and that is exactly what happens inside the perfusion device.
How does it work?
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The device is a sterile box inside which the heart is kept. It is fed with warm, oxygenated nutrient rich oxygenated blood on a continuous basis. The entire carbon fiber system is about one meter high and rests on a platform with 4 wheels enabling free movement along hospital floor.
It is fitted with an oxygen tank, a continuous supply of blood, batteries and mechanical gadgets to monitor the heart health with a sterile plastic case encapsulating the donor heart making it suitable for transportation. Ambient temperature and the right moisture level are ensured inside the device.
The warm perfusion device would enable donation of heart even after circulatory death. It sounds fabulous indeed! Even after the clinical death of the donor, his/her heart, which still functions, could be carried inside the box and transplanted to a patient who badly needs it.
Enabling the heart kicking alive in the box:
Dr. Waleed Hassanein, the President and CEO of Trans Medics, the Andover, the medical device company that has been developing the system sounded enthusiastic since this would keep the heart kicking and alive inside the box.
While the heart keeps beating and functioning normally inside an alien system that exactly simulates the body environment of a human being, specialists can closely study its health and can even administer antibiotics in case it has been infected.
In last August, the heart box was put to a test on a patient where the heart was kept inside the warm perfusion device for a span of 3 hours. It is likely that the same test would be repeated for 5 patients in a short while where the time span for which the heart would stay inside the box would be elevated to 24 hours.
The developer of the system Dr. Stig Steen of the Lund University, Sweden sounds quite optimistic. He is confident that the heart can stay well and healthy inside the heart box for several days.
This medical breakthrough would increase the number of healthy hearts available outside the donor body to meet the ever increasing demand by making up the distance gap between the donor and the patient. While everything sounds fine, the high price tag of $250,000 that accompanies the device may prevent many hospitals adopt this device fearing a sharp rise in the treatment cost.
