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Doctors Testing Warm, Beating Hearts In Transplant

Mon, 12/06/2010 - 6:12am

Alicia Chang, AP

Andrea Ybarra's donated heart was beating rhythmically by the time she awoke from the grogginess of her surgery. Lub-dub. Lub-dub. Lub-dub. In fact, it was warm and pumping even before doctors transplanted it. Ybarra belongs to a small group of people who have had a "beating heart" transplant, an experimental operation that's mostly been done in Europe. The donor heart is placed into a special box that feeds it blood and keeps it warm and ticking outside the body.

"I felt peaceful when I woke up. I wasn't scared," recalled the 40-year-old from a Los Angeles suburb who suffers from lupus. "It felt like the heart was a part of me all the time." Despite advances in heart transplantation, the way hearts are moved around the United States and most places remains low-tech. A team of doctors and organ recovery specialists stuffs an off-the-shelf picnic cooler with ice and jets off at odd hours to a donor hospital where a heart from a brain-dead patient awaits. They inject a chemical to stop the organ and preserve it in the ice chest for the trip home.

Once a heart is harvested, it's a race against time. A heart can stay fresh in the cooler for 4 to 6 hours before it starts to deteriorate. Because of this constraint, doctors can't travel too far to heart-hunt. It's been done this way for more than four decades, ever since the first U.S. heart transplant was performed on Dec. 6, 1967. Research has shown that the longer it takes to remove a heart and transplant it, the greater the patient's chance of death or heart disease.

But what if a heart could beat on its own after removal from a cadaver? It may sound a bit macabre, more like an Edgar Allan Poe story. The new high-tech heart box circulates blood from the donor to the heart so that it continues throbbing while in transit from hospital to hospital. Based on some success overseas, the University of California, Los Angeles is currently heading an experiment along with several other schools that compares the safety and effectiveness of the new preservation method versus the standard cooler.

If the new technology succeeds in preserving hearts longer, it could change the field, experts say. No longer will patients be limited by location. Doctors could make cross-country heart runs without worrying about how long it takes. Hearts are now given first to people on the waiting list who live near where the donor is hospitalized. If there's no match, then the circle widens until a recipient is found.

"The rush factor will be taken out. I can go all the way to the West Coast to get a heart," said Dr. Bruce Rosengard of Massachusetts General Hospital, who performed the first beating heart transplant in the United Kingdom in 2006. It may also potentially help ease the organ shortage crisis. Some 3,000 Americans are currently on the heart transplant waiting list. Last year, 359 died waiting for a heart.

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