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New Technology Keeps Donor Hearts Beating Longer During Transport

Analysis  |  By Scott Mace  
   September 14, 2022

Atrium Health Sanger Heart & Vascular Institute is using a new portable system that increases the time and range of viable organ transports.

Atrium Health's Sanger Heart & Vascular Institute is using a new technology platform developed by digital health company TransMedics that preserves donated hearts, enabling transplant teams to expand travel time and reach more patients in need of a heart transplant.

The TransMedics Organ Care System (OCS) is designed to prolong the amount of time a donated heart can be viably transplanted, allowing health systems who perform transplants to expand their coverage area for donors and recipients.

“Once a heart is removed from a deceased donor due to cardiac death, the portable system revives the heart and keeps it beating, infusing it with blood from the donor that is supplemented with nutrients and oxygen,” Eric Skipper, MD, a cardiothoracic heart transplant surgeon at Atrium Health Sanger Heart & Vascular Institute, said in a press release. “The system also allows us to carefully assess the heart’s functional quality and viability for transplant before we reach the operating room to perform the transplant.”

In the past, the Charlotte, North Carolina-based Sanger Heart & Vascular Institute transplant team only accepted donor hearts within a 500-mile radius, as the organ could only be placed in cold storage for four hours. The new technology expands that range, because the heart can be kept viable for up to eight hours and be transported from up to 1,000 miles away.

The new technology also permits acceptance of higher-risk hearts, including those from older donors and donors who are initially put on life support before withdrawing care, a condition commonly known as donation after cardiac death.

Atrium Health officials said the institute recently completed its first heart transplant using the OCS platform.

“This was a patient who was potentially looking at a long wait for an organ transplant,” Skipper said in the press release. “But because of the ability to utilize this technology, they were able to receive a heart very quickly.”

In April 2022, the US Food and Drug Administration approved use of OCS to preserve hearts for transplant after cardiac death. Results from a multi-center clinical trial compared the use of the technology to the traditional cold storage method of preserving donated hearts during transport. Using the OCS resulted in 90 patients (of the 180 randomized and transplanted patients) receiving organs that were previously unable to be used prior to this technology, the clinical trial results reported. Those recipients had a one-year survival rate of 93.3%, as opposed to an 87.3% one-year survival rate among the control group where OCS was not utilized.

“We were always limited to accepting organs from donors who suffered immediate brain death,” Joseph Mishkin, MD, an advanced heart failure transplant cardiologist at Sanger Heart & Vascular Institute, said in the press release. “We now can accept organs from donors who have suffered an irreversible brain injury but do not meet formal brain death criteria. In these instances, the family has decided to withdraw care. The donor’s organs can now be a life-saving gift for others.”

More than 3,300 people are on the waiting list across the US for a heart transplant. Of those, 95 are in North Carolina, according to the US Department of Health & Human Services Organ Procurement and Transplantation Network.

“We face a nationwide shortage of donated organs," Mishkin said. "I expect this technology to transform the transplant industry, increasing the national donor supply and helping us transplant more patients in need."

Scott Mace is a contributing writer for HealthLeaders.

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