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The Cutting Edge

Heart in a Box

Heart in a BoxSINCE THE ADVENT OF TRANSPLANTATION, the only method to preserve a donor heart has been to place it in a cold preservation solution during transport to the recipient. But that may change with a new heart-preservation system designed to maintain the organ in a warm, beating and functioning physiologic state outside of the body.

“Human hearts were never meant to be put on ice in a cooler,” says Abbas Ardehali, M.D., surgical director of the UCLA Heart and Lung Transplant Program. He also is principal investigator of the Organ Care System – also known as “heart in a box” – trial in the U.S., which is being conducted at UCLA and four other leading heart-transplant centers across the country.

Many major transplant centers only consider using donor hearts that can be transplanted within six hours or less of recovery. Using a new organ-preservation system in which the heart is revived to a beating state, protected within a sterile chamber and continuously perfused with warm, oxygenated, nutrient-rich donor blood, the heart may potentially be kept outside of the body for longer periods of time. “If we’re able to safely transport donor hearts across longer distances, from the East Coast to West Coast for example, we may be able to increase the pool of donor hearts available to patients,” Dr. Ardehali says.

Another potential benefit of the new system, Dr. Ardehali adds, is the ability to more comprehensively assess the heart prior to implantation using imaging, functional and metabolic testing. This may lead to improved immediate and longterm heart function, reduce the risk of organ rejection and increase the number of hearts accepted for transplant.


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