Reanimating “Dead” Donor Hearts

Patients who received a donor heart that had stopped and its owner died in so-called circulatory death were just as likely to survive 6 months as those who received hearts from brain-dead donors whose hearts were actively beating at the time of donation. This remarkable multicenter study, headed by Duke University cardiac transplant surgeons, used the “heart in a box” Organ Care System developed by the Andover, MA-based TransMedics company to bring “clinically dead” hearts back to life by perfusing them with warmed, oxygenated blood after they have been electrically shocked. The system permits testing of the heart to be certain that it will support life.

The study compared 80 patients who received hearts from circulatory-dead donors with 86 who received hearts from brain-dead donors. The 6 month survival of those patients receiving resuscitated hearts was 94%, statistically no different than the 90% figure for those receiving hearts that had never actually stopped beating. There were more post-surgery graft issues with the reanimated hearts, but all were manageable.

This is a game changer since the supply of donor hearts, currently in terribly short supply, could be expanded by as much as 30%. As I file this report, the only organs transplanted from circulatory-dead donors are kidneys, livers, and lungs. This new technique will change that and save many lives….someday soon.

https://www.nejm.org/doi/full/10.1056/NEJMoa2212438

#heart #circulatorydead #braindead #transplantation #transmedics