‘Heart in a box’ keeps organs alive outside of the body
According to The Lancet TransMedic's Organ Care System (OCS) device is the first medical device capable of maintaining donor organs in an optimal state outside of the human body for longer than six hours
The device can keep a heart alive from the moment it is removed from a donor’s body until it is placed into the recipient’s body.
The current method of organ preservation for transportation and transplant has been cold ischemic storage (placing organs on ice). This method is intended to reduce the extent of organ damage during transport however deterioration of the donated organ still occurs. The longer the organ is kept on ice, the greater the damage.
TransMedics’s OCS device minimises cold ischemia injury by filling the heart with warm oxygenated blood, optimises the condition of the organ by replenishing oxygen, nutrients, and hormones that would otherwise become depleted and provides continuous monitoring and assessment of the organ until the point of transplantation.
The OCS device by TransMedic has also opened the door for DCD donors, a previously unsuitable source of donors, to be used.
DCD donor hearts are from donors whose hearts stopped beating in their bodies. The use of other organs from DCD donors is current practice but has not been possible with hearts until now because heart tissue rapidly deteriorates when the heart stops beating and blood is no longer being circulated around the heart.
However, using TransMedic’s OCS technology, the heart transplant team at St. Vincent’s Hospital, Sydney completed the successful transplants from DCD donors in 2014. Subsequently seven sites across the United States have been testing the OCS device.
Jason Smith, a cardiothoracic surgeon and transplant specialist at UW Medical Center, one of the sites to use the OCS device, said: “The technological advance of this device is that it circulates blood into the aorta and the coronary arteries, and the heart will be beating again all the way to its new home.
“The idea is that because blood is perfusing the heart, you can keep the organ out of the body considerably longer. In Europe, they’ve gone up to 11 hours on the machine and still had a successful transplant,”
TransMedics has said that the use of DCD hearts in the future promises a potentially significant increase in the number of transplantable hearts available to patients suffering from heart failure.
Dr. Waleed Hassanein, president and CEO of TransMedics, said: “The ability to safely transplant a donor heart from DCD donors could be a paradigm shift to potentially increase the pool of viable donor hearts to help more patients suffering from end-stage heart failure.
“The publication of this successful case series creates a scientific foundation to a new and large potential source of heart transplants for patients that need a heart transplant to treat their end-stage heart failure.”