A new method to preserve donor hearts has tripled the amount of time they can be kept alive outside the body, providing hope that lives will be saved by organs previously deemed unsuitable for transplant.
The Alfred hospital’s head of cardiothoracic surgical research, Frank Rosenfeldt, has pioneered the approach, which uses a portable device to perfuse a solution of oxygen and nutrients into hearts removed from a deceased donor.
Waste is also flushed out of the heart to mimic processes in the body.
Researchers found the method expands the time that hearts can be kept outside the body before being successfully transplanted in large animals.
They recently kept a human heart viable for 12 hours – three times longer than the current four-hour window – and are working towards transplanting a human heart preserved using the new method at The Alfred hospital within 18 months.
Professor Rosenfeldt said the new method was an advance on the current approach of putting hearts on ice, which keeps the heart at a low temperature but does not supply oxygen or nutrients.
Perfusion can preserve hearts that would not currently be considered viable for transplantation, especially during transport over long distances.
Professor Rosenfeldt said the new approach would allow Australian patients to receive more donor hearts from interstate and New Zealand.
Currently hearts are considered for donation only in patients declared brain dead whose heart will stop beating once life support is removed.
But Professor Rosenfeldt’s team has also shown that the device can preserve hearts donated shortly after circulatory death, where the heart has stopped beating for up to 30 minutes. Currently heart transplants are not considered viable in such circumstances.
A total of 72 Australians received life-saving heart transplants in 2012 but a further 78 patients were still waiting for a donor heart at the end of that year. About one in five patients dies while waiting for a donor heart.
Professor Rosenfeldt said the new method of preserving hearts could provide a lifeline for some of these patients, potentially allowing dozens of extra transplants to be performed in Australia each year.
Alfred hospital cardiothoracic unit deputy director Silvana Marasco said the new method ‘‘could be a turning point in the history of heart transplantation if we can pull this off safely’’.
She said Australia’s big distances and relatively small population had forced doctors to preserve donor hearts outside the body for up to six hours in some cases, although this came at a cost with hearts often slower to recover and patients requiring long stays in intensive care units.
The development has been welcomed by Mark Macleod-Smith, 44, who has been on the waiting list for a heart transplant for the past 18 months.
The father-of-two’s heart failed following complications from a virus and he has been fitted with a mechanical device to support his ailing heart while he is waiting for a transplant.
In the meantime Mr Macleod-Smith needs to stay within an hour’s travel of The Alfred hospital, is unable to work and faces restrictions including being unable to drive or shower properly.
‘‘Anything that can widen the pool of donors would be great . . . it’s an amazing gesture from a donor’s point of view to say you can have this organ but if they can’t use it because of distance it’s a terrible waste,’’ he said.
