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When the heart stops beating, it almost immediately begins to die. With no fresh blood to deliver the oxygen that heart cells need to survive, it is only a matter of minutes before organ damage becomes irreversible.
For this reason, most successful heart transplants are performed with hearts that are kept beating with a ventilator machine after the death of their donors.
Dr. Mitesh Badiwala, an award-winning cardiac surgeon at the Peter Munk Cardiac Centre and Surgical Director of Heart Transplantation at UHN, has demonstrated in experimental models that when properly preserved, hearts that have stopped beating can be successfully transplanted.
This success may enable more donated hearts that can be transplanted, and improve the chance for those with advanced heart failure to receive a new heart.
Currently, portable ventilators are used to keep donated hearts beating during transportation to the recipients. This limits the number of hearts that can be transplanted and prevents many hospitals from performing more transplant surgeries.
Further testing required to establish safety
Dr. Badiwala and his colleagues investigated cold storage as an alternative solution to preserve the heart prior to transplantation. They demonstrated in experimental models that the heart can tolerate more than two hours of storage at room temperature or lower – and still be transplanted successfully.
"Heart donors are few, while those in need of a new heart are many," explains Dr. Badiwala. "By preserving the heart at lower temperatures and in specially designed fluids that reduce further damage, we can transport the heart to the recipient without the use of a portable ventilator."
Further testing is required to establish the safety of this strategy.
If successful, this strategy has the potential to increase the pool of available organs and reduce the cost of heart transplant surgeries.
This work was supported by the Toronto General & Western Hospital Foundation.