Organ Care Technology Pivotal in First Dead Heart Transplant

Innovative technology was used to preserve and assess the world's first series of heart transplant procedures from donors after circulatory death (DCD).

The hearts were retrieved, resuscitated, to a normal beating state, and clinically assessed using the TransMedics Organ Care System (OCS) heart technology platform, which is capable of maintaining donor organs in near physiologic and functioning state outside of the human body from the time the organ is removed and until it is ready to be transplanted into a suitable recipient. The technology has the potential to significantly increase the organ donor pool and utilization of current donor organs; improve patient survival; reduce post-transplant complications; and improve cost-effectiveness of the transplant procedure.

The technology works by providing a comprehensive solution to three key limitations of the cold storage technique. It minimizes cold ischemia injury by perfusing the heart with warm oxygenated blood; optimizes the condition of the organ by replenishing oxygen, nutrients, and hormones that would otherwise become depleted; and provides continuous monitoring and assessment of the organ until the point of transplantation. The TransMedics Organ Care System (OCS) is a product of TransMedics (Andover, MA, USA).

“The ability to safely transplant a donor heart from DCD donors could be a paradigm shift to potentially increase the pool of viable donor hearts to help more patients suffering from end-stage heart failure,” said Waleed Hassanein, MD, President and CEO of TransMedics. “We are actively engaged in four large pivotal trials for hearts, lungs and livers in the United States to bring the revolutionary OCS technology to the US market.”

“The OCS Heart system was paramount to the success of this clinical milestone in heart transplantation, as it enabled us to fully assess the donor heart function and metabolic state before transplantation,” said Professor of cardiothoracic surgery Kumud Dhital, MD, of St. Vincent's Hospital (Sydney, Australia), the lead surgeon who performed the world's first series of three successful DCD adult heart transplant procedures.

The cornerstone of organ preservation is cold ischemic storage. Although this method is intended to reduce the extent of organ damage during transport, significant deterioration of the donated organ still occurs; the longer the organ is kept on ice, the greater the damage. Moreover, the cold storage technique does not enable any resuscitative or assessment while the organ is being transported from donor to recipient. It is estimated that 60%–65% of donor hearts globally cannot ultimately be used for transplantation due to the limitations of cold storage.

Related Links:
TransMedics
St. Vincent's Hospital