The problem: Hearts for transplant must be transported from donor to recipient within about four hours before complications begin to develop. The hearts are placed on ice inside picnic coolers for the drive or flight from one hospital to another. That means traffic jams, bad weather and mechanical problems can cause such serious delays that a heart ends up being wasted. It means the heart can be damaged when it's warmed up at the end of the surgery. And it means the heart can't be put through a battery of tests to see how well it works until after it's been transplanted. That's a big problem for patients receiving new hearts. Five percent to 7 percent of hearts end up not working after they've been transplanted. Those patients have to undergo major surgery again -- and risk death -- sometimes days after the original surgery.
By keeping a donor heart beating en route to transplantation, rather than sitting in a cooler full of ice, TransMedics' Organ Care System, known as Heart in a Box, allows the heart to arrive in better shape.
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Source: TransMedics Inc.
Illustration by: William Neff | The Plain Dealer;
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The solution: Heart in a Box. You might have seen it on an episode of "Grey's Anatomy" and thought it was fantasy. But it's in use in Europe. And Heart in a Box, formally known as the Organ Care System, is being tested in eight hospitals in the United States, including the Cleveland Clinic, to see if it works well enough to be approved by the FDA.
The sterile box, made by TransMedics Inc. in Andover, Mass., is heated and includes a small device that pumps warm, oxygenated blood -- from the donor -- through the heart the entire time it's in transit, which means it keeps beating and can be outside the donor body for as long as 12 hours. The still-beating heart also can be monitored en route just like it's still in the patient so doctors can keep it in optimal condition. In the end, the patient gets a healthier heart with less chance of rejection and smaller risk of death.
In the future, TransMedics hopes to conduct a study to see if patients who receive Heart in a Box hearts live longer than those whose hearts are transported the conventional way.