‘Heart in a box’ now a proven gamechanger

Presenting the findings of their two year study, Prof David Kaye and Prof David McGiffin have told the International Society for Heart and Lung Transplantation meeting in Denver that hypothermic machine perfusion can safely keep donated hearts alive outside the body for almost up to nine hours - more than double the current standard time using ice slush.

The technique works by continuously cooling a retrieved donor heart at 8°C while supplying it with a nutrient-rich oxygenated solution.

Prof Kaye says this represents a significant breakthrough in the number of hearts that can be transplanted in Australia, given the vast distance between capital cities. 

“We hoped that the procedure, originally developed in Sweden, would lengthen the time limit from less than four hours for traditional storage using ice, however this was yet to be confirmed in a clinical study,” Prof Kaye said. 

“With clinical evidence we now know that the donor heart is better protected with ex-vivo perfusion as opposed to ice slush in a cooler.” 

Prof Kaye said the patients in the trial had recovered well, which could be in part attributed to the nutrition and oxygen provided to the donor heart by the perfusion system. 

“The best chance that a patient has of surviving heart transplantation is if they come out of the operating room with a well-functioning heart despite a very, very long ischemic time, and that’s what the results have shown.” 

Several sites across Australia and New Zealand were part of the trial, with The Alfred the first to perform five transplants. 

Other sites included the Royal Children’s Hospital Melbourne, St Vincent’s Hospital Sydney, Fiona Stanley Hospital Perth and Auckland City Hospital in New Zealand.

Pre-clinical research was led by the Critical Care Research Group in Brisbane. 

XVIVO Perfusion in Sweden developed the non-ischemic heart preservation method being used in the study.