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Norfolk man in pioneering donor heart op

PUBLISHED: 09:00 05 June 2006 | UPDATED: 10:57 22 October 2010

MARK NICHOLLS

A Norfolk man has become the first UK patient to receive a new “beating heart” during a ground-breaking transplant operation using a new device that is set to have massive implications for organ donation.

A Norfolk man has become the first UK patient to receive a new “beating heart” during a ground-breaking transplant operation using a new device that is set to have massive implications for organ donation.

Under the new procedure, the 58-year-old volunteer was given a heart that was kept beating mechanically by a revolutionary system that has been specially designed to keep human organs in a functioning state while outside of the body - allowing them to be more easily transported from one hospital to another before being transplanted into the patient.

Normally, donor hearts lie dormant in cold fluid for 4-6 hours before being given to recipients. But the new process means the hearts lie inactive for shorter periods - a move which looks set to give a better chance of saving lives.

The UK's first successful beating heart transplant operation was carried out on May 22 by a team of surgeons led by Professor Bruce Rosengard at Papworth Hospital near Cambridge but details have only been released today.

The operation - the first in the UK in trials of the new organ conservation system - may mean hearts and other organs that were previously less suitable for transplant can be “revived”, and successfully used in the life-saving surgery.

The Norfolk man who received the heart has not been named but Prof Rosengard said he is back on a ward and doing “extremely well.” It has also emerged that he volunteered to be the first patient to receive this type of heart in the trials.

Prof Rosengard told the EDP: “He did have the opportunity to have a routine transplant but he decided it was important to do it this way. He is proud of the fact that he has been involved and told me that he felt sometimes people have got to stand up and be guinea pigs to help make these advances happen.”

Experts also hope the new system will have the capability to revive organs from donors whose hearts have already stopped beating.

Prof Rosengard added: “The implications are manifold. More research and development needs to be done but what this will mean is that we can double, possibly triple or potentially quadruple the total number of transplants we can do a year.”

UK Transplant - a body which ensures that donated organs are matched and allocated in a fair and unbiased way - says more than 8,000 people currently need an organ transplant in the UK but due to a severe shortage of donated organs, fewer than 3,000 operations are carried out each year and around 400 people die every year while waiting for a suitable organ to become available.

There are currently 104 people, including nine children, registered for a heart transplant in the UK, with a further 43 patients waiting for a combined heart and lung transplant including two children. Last year - from April 1, 2005 to March 31, 2006 - a total of 146 people received a heart or heart and lung transplant, down from 170 during 2004-05.

News of the operation comes on the day that the Norfolk and Norwich University Hospital launches its own angioplasty facility where arteries in the heart are unblocked.

Using the new device means that the donor heart only stops beating for the 20 minutes it takes to attach to the device and the hour needed to sew it into the recipient.

Chris Rudge, Managing and Transplant Director of UK Transplant, said: “UK Transplant welcomes any initiative to improve organ quality and availability for patients. As the Organ Care System evolves in the future it offers great promise not only for patients awaiting heart transplantation but also for those awaiting other donated organs.”

The European trials for the system are being carried out in the UK at Harefield Hospital in Middlesex and Papworth - the centre where people from Norfolk, Suffolk and Cambridgeshire are given heart and lung transplants or have other major cardiac operations such as by-pass surgery - and at units centres at Berlin and Bad-Oeynhausen in Germany. A further trial planned for North America has yet to start.

The trial is intended to do transplants on 20 patients in the four centres. Three have been carried out so far with the Papworth op the first in the UK.

Prof Rosengard said: “The device has worked very well thus far, in our case it has been spectacular.”

SIDEBAR

Health Correspondent Mark Nicholls examines how the new system works and what the benefits will be

The new system for organ conservation, TransMedics' Organ Care System, is designed to keep human organs in a functioning state while outside of the body.

It means the organs can be kept in better condition, more detailed testing can be carried out to match them more closely with a recipient and the time between removal and transplant can be extended.

For this operation the heart was removed from the donor at Addenbrookes Hospital in Cambridge, placed into the Organ Care System, revived to a beating state, perfused with oxygen and nutrient-rich blood (also taken from the donor) and maintained at the appropriate temperature as it was taken to Papworth and sewn into the recipient.

Conventional transplant technology keeps organs waiting to be transplanted in a cold state with no blood circulation, which means that they begin to deteriorate after 4-6 hours and quickly become unsuitable for transplant.

But the new system has several benefits:

t surgeons have the opportunity to evaluate the organ immediately prior to transplant and to test it even more extensively for existing diseases;

t more comprehensive tissue matching may also be possible in the future, which could reduce the risk of organ rejection;

t experts say the new approach is designed to reduce the risk of organ damage during preservation and improve the quality of life for the patient after transplantation;

t the window of time between removal and implantation could be extended with the help of the Organ Care System. This may allow organs to be transported to more distant locations, broadening the number of usable organs as well as the number of potential recipients.

Conventional conservation methods have a number of disadvantages. Cold storage of organs can lead to substantial organ damage in isolated cases. The faster the organ reaches the patient, the better the chance for a successful transplantation.

International data shows that the outcome of heart transplant patients who receive a donor heart four hours after its removal from the donor is significantly worse than those of patients who promptly receive a donor organ.


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