For over 40 years, transporting hearts for the purpose of transplantation has been accomplished with little more than coolers and ice. Now a study being headed up by members of UCLA's lung and heart-lung transplant team is seeing if they can bring the field of heart transplantation into the 21st century by transporting donor hearts in a beating state.
In other words, no more hearts on ice. In traditional methods of heart transplantation, the donor heart is injected with potassium chloride to stop its beating, and is then packed on ice before rushing it off to the transplant recipient. Under these conditions, the heart can be preserved for about 4-6 hours.
But UCLA Medical Center — along with Washington University Hospital in St. Louis and Columbia University Medical Center in New York — is collaborating with medical device company TransMedics in an ongoing phase II clinical trial to see if hearts can be transplanted in a more physiologically normal state.
The revised transplantation procedure forgoes the use of potassium chloride and ice in favor of TransMedics's Organ Care System (OCS), which preserves the donor heart at an internal body temperature and allows it to continue beating and flowing with warm, oxygenated blood.
Trials have already shown that the device is capable of preserving donor hearts for longer periods of time that the traditional, iced-method of transport, and current studies are looking at whether hearts and their recipients hold up as well following transplantation as patients who are transplanted with hearts preserved on ice.
It will be very interesting to see what information the trials produce. Assuming the trials are successful, a system that can preserve a donated heart in a near-normal physiological state has enormous implications for the field of transplant medicine. Consider, for example, how it might affect the overall process of organ donation; being able to preserve organs for longer periods of time, and transport them longer distances, will introduce entirely new variables into the process of determining who receives priority in receiving donor organs.