Until now cold preservation on ice has been the standard technique to preserve donor hearts. A large international trial, led by UZ Leuven, is now studying whether the heart can also be preserved with the help of a machine and an especially developed cold solution.
The new technique boosts the chances of a successful transplant. “When the donor heart is preserved on ice, the chance of serious heart failure increases as soon as the heart is preserved outside the body for more than three hours. With the perfusion machine we can maintain a constant, ideal temperature as well as administer extra nutrients. Like this, the heart can be preserved for up to 24 hours and continues to function well afterwards”, says professor Filip Rega, staff cardiac surgeon at UZ Leuven, who performed the operation.
Other organs, such as kidneys, are being stored in this manner with good results for some time already. “Cardiomyocytes are complex cells. They are lot more sensitive to oxygen deficiency than liver, kidney or lung cells. The fact it takes so long before we can introduce new techniques, is mainly due to the nature of the cells.
High demand for donor hearts
Nowadays, transplant surgeons are faced with a number of problems. On the one hand, there is a big shortage of donor organs. On the other, there is a great need for a way to preserve donor hearts for longer. “Today we are transplanting patients with much more complex disorders than we used to. Often they will already have undergone multiple open heart surgeries before their transplant. This makes transplanting more difficult and the donor heart will have to be preserved outside the body for longer. This trial offers a solution for this problem”, according to professor Van Cleemput, staff cardiologist at UZ Leuven and medically responsible for the trial.
This international trial is conducted in eight large transplant centres, including centres in Paris, Berlin, Munich and Madrid. The new storage technique was developed by professor Stig Steen (Lund University).