Novel Transplant Technique Yields More Donor Hearts for Children
Two hospitals in the UK have reported great success in a new heart transplant technique, resulting in a record number of children receiving heart transplants in 2020.
Royal Papworth Hospital in Cambridge and Great Ormond Street Hospital (GOSH) have collaborated on a new procedure which has enabled a much larger supply of donor hearts for children, who have had to wait two and a half times as long as adults for a donation.
Royal Papworth Hospital was the first in Europe to harvest non-beating hearts from adult patients whose life support had been withdrawn, and then been restarted for transplantation, instead of waiting for brain death with a still-beating heart.
By using a special device called the organ care system, surgeons can effectively restart the heart and keep it healthy until transplantation. The first non-beating heart transplant was performed in Australia in 2014. Since February last year, the two hospitals have been offering the service to children.
The use of non-beating hearts had previously been ruled out for transplantation until recently, due to tissue damage from lack of oxygen. The new organ care system, which supplies the heart with oxygenated blood and nutrients, can be used to keep the heart alive and pumping outside the body for up to 12 hours. This is long enough for checks to be performed prior to the transplant procedure, or even transferred to another hospital.
GOSH and Freeman Hospital are the only two centres in the UK with paediatric heart transplant units. In the past five years, 39 children died while waiting for donors.
“Some patients will just not survive the wait,” said Jacob Simmonds, a transplant surgeon at GOSH. “There is also a risk that while waiting they could damage other organs, particularly the lungs.”
Last year, six paediatric heart transplants were carried out in the UK using the new procedure, and only four elsewhere in the world. The organs came from adult donors, as the organ care system is designed to accommodate hearts from people weighing over 50kg. Development is being carried out on a system which could allow harvesting organs from children. This would increase the available transplants for infants and babies, who have a critical lack of donors.
Source: BBC News
