Heart transplant

Northwestern Performs First Heart Transplant in Illinois Using Heart-in-a-Box Device | Illinois

For the first time in Illinois, surgeons have successfully removed a heart that had stopped beating inside a patient and transplanted it into another person using a new science-based device. fiction.

Surgeons at Northwestern Memorial Hospital announced Wednesday that they performed a heart transplant on Oct. 12 using a machine dubbed “heart in a box.” It’s a breakthrough that doctors hope will make more hearts available for transplant. About 3,400 people across the country are now waiting for heart transplants, including 182 in Illinois.

Usually, hearts are only considered for transplant if a donor is brain dead, but the donor’s heart is still beating in their body, either on their own or with mechanical assistance. This can sometimes happen after a traumatic injury or drug overdose. In these cases, the heart is removed from the donor’s body and placed on ice to be transported to a recipient, which must occur within about four hours.

The heart-in-a-box device, however, allows surgeons to use hearts from donors who suffer circulatory death, which is when the heart and respiratory system shut down. Once the heart has stopped beating, surgeons have about 30 minutes to retrieve it and place it in the device. The device then resuscitates him and keeps him moving by pumping warm, oxygenated blood through him, until he can be transplanted into a donor.

The patient who received the heart at Northwestern is doing well and was preparing to go home earlier this week, said Dr. Benjamin Bryner, associate director of heart transplantation and mechanical support, and director of the expanded donation program at Bluhm Cardiovascular Institute of Northwestern Medicine. .

“I think this is one of the most significant advances in heart transplantation in decades,” Bryner said. “It opens a lot of hearts that were kind of thrown away.”

Bryner estimates the device could increase the number of heart transplants by about 20 to 30 percent at Northwestern and nationwide. Northwestern now performs about 30 to 40 heart transplants a year, Bryner said.

Until now, patients could generally only be considered potential donors if they were brain dead, which limited the number of hearts available. The new technology allows surgeons to take the hearts of patients who are not technically brain dead but have no hope of recovery.

These patients may also have suffered a traumatic injury or drug overdose and have lost almost all brain function, but are not considered brain dead because they may have an intact reflex or a small trickle of blood in the brain. brain, Bryner said. . They are not considered donors unless there is more hope, he said.

If a patient reaches this point, the patient’s family may make the decision to remove the person from life support, so that they stop breathing and their heart stops beating. The person then suffers circulatory death and surgeons can retrieve the heart and place it in the device for transport to another patient.

Because the device keeps the heart going, surgeons have more time to transplant it than with traditional methods. The device can keep the heart viable for eight or nine hours, compared to about four or five hours when a failed heart is on ice before a transplant.

“With traditional methods, we are limited in terms of the time and distance we can travel,” said Dr. Duc Thinh Pham, director of heart transplantation and mechanical circulatory support at Northwestern’s Bluhm Cardiovascular Institute. “This device allows us to travel longer distances and for a (longer) travel period.”

The device also gives surgeons more time to examine the condition of a heart, looking for signs of injury or coronary disease, before it is transplanted to another patient.

“Before, it was too risky to take a heart that had already stopped in someone and implant it and hope it would work,” Bryner said.

Only a handful of US hospitals have used the technology to perform heart transplants, although hospitals in the UK and Australia have used it for years, according to Northwestern. The technology is similar to that which has been used to transplant livers, lungs and kidneys in recent years, including in the Chicago area.

The new portable device is called TransMedics Organ Care System Heart System and was recently approved by the US Food and Drug Administration for use with donor organs after circulatory death.

A paper published in the journal Cureus earlier this year noted that the technology has the potential to increase the number of hearts available for transplantation, but is expensive and may be more complex to transport than hearts stored at the facility. ice aid.

Pham called the device one of the biggest developments he’s seen in heart transplantation and said it could benefit more heart failure patients. He also urges people to register to become organ donors.