Australian doctors have successfully brought three dead hearts back to life and transplanted them into patients in a world-first operation. The doctors at St Vincent’s Hospital in Sydney used a preservation solution developed with the Victor Chang Cardiac Research Institute to transplant the organs into 57-year-old Michelle Gribilas, 44-year-old Jan Damen and a third patient still in recovery. One of the hearts had stopped beating for 20 minutes before it was brought back to life, placed on a machine and injected with the preservation solution.
The hospital believes 30 percent more lives will be saved thanks to the solution, which reduces the amount of damage to the heart and makes it more resilient to transplantation. Before these operations, heart surgeons have only been able to use donor hearts from 100 percent brain-dead patients, but now the donor pool will be expanded significantly. The solution, which took 12 years to develop, also improves the function of the hearts donated after circulatory death (DCD) when they are restarted. Ms Gribilas, who is retired and lives in Campsie in southwest Sydney, said she is a ‘different person altogether’ after receiving her transplant. ‘I had the transplant a couple of months ago and I was very sick before I had it,’ she said. ‘Now I feel wonderful.
I walk three kilometres a day.’ Mr Damen, a father of three girls including an eight-year-old and six-year-old twins, worked as a carpenter and lives on the Northern Beaches with his daughters and wife Silvana. He is still recovering at the hospital. ‘I feel amazing,’ he said. ‘I have to say I never thought I’d feel so privileged to wear the St Vincent’s pyjamas. ‘I’m just looking forward to getting back out into the real world.’ Mr Damen said he often thinks about his donor. ‘I do think about it, because without the donor I might not be here,’ he said. ‘I’m not religious or spiritual but it’s a wild thing to get your head around.’ Previously, surgeons were only able to use hearts from donor patients who were 100 per cent brain dead.
These patients’ hearts are kept alive and beating by life support machines and are able to be removed from the donor patient and placed straight into a Transmedics machine which keeps the heart pumping, with minimal damage to the organ. But the new solution allows transplants using hearts from 90-95 percent brain dead patients, which were previously thought to be too damaged to use. When a 90-95 percent brain-dead patient’s life support is switched off, the heart gradually stops beating over a period of about 20 minutes. Under Australian law, surgeons must wait until there has been no heartbeat for five minutes before the organ can be removed.
The lack of oxygen during this time causes significant damage to the heart and until now has meant those hearts could not be used for transplants. But when the new solution is injected into the heart its cells start to regenerate. One of the surgeons who performed the operations, Dr Paul Jansz, said the technology would have implications for transplant units around the world. ‘North America and Europe are very envious that we were able to get on and do this,’ Dr Jansz told Daily Mail Australia. ‘Many prestigious units around the world have been working towards this and haven’t been able to pull it off. ‘It literally is a world first, it means a lot for the transplant world.’
Dr Jansz said the technology was approved in the last year and since then three patients have successfully received transplants. ‘We did one yesterday, one about two weeks ago and the first one was about nine weeks ago,’ he said. ‘Hopefully we will do many more, this technology will only get better and will only be able to expand on the limitations.’ Prof MacDonald, the director of the Hospital’s Heart Lung Transplant Unit, said the team had been working on this project for 20 years and intensively for the past four. ‘We’ve been researching to see how long the heart can sustain this period in which it has stopped beating,’ he said. ‘We then developed a technique for reactivating the heart in a so-called heart in a box machine.
‘To do that we removed blood from the donor to prime the machine and then we take the heart out, connect it to the machine, warm it up and then it starts to beat.’ The donor hearts were each housed in this machine for about four hours before transplantation, he said. ‘Based on the performance of the heart on the machine we can then tell quite reliably whether this heart will work if we then go and transplant it. ‘In many respects this breakthrough represents a major inroad to reducing the shortage of donor organs,’ he said.