'Dead heart' transplants offer hope to patients here

A new method devised by Australian surgeons to transplant "dead" hearts holds promise for heart failure patients here, but it is still too early to jump into this technology, experts said.

More research needs to take place before the technique can be adopted here, say doctors at the National Heart Centre Singapore (NHCS).

"This will definitely be the future of heart transplantation," said adjunct associate professor Lim Chong Hee, who is director of the centre's heart and lung transplant programme.

"It is still too early to jump into this technology, but the future looks promising in that we can get several more sources of hearts, other than brain death donors."

These include patients whose hearts have already stopped beating, he said, as well as poorly functioning hearts from brain-dead patients who would otherwise not be eligible donors.

Last week, doctors from the Sydney-based St Vincent's Hospital and Victor Chang Cardiac Research Institute announced that they had successfully resuscitated hearts which had stopped beating for 20 minutes.

These hearts were placed in a special machine to keep them warm and restore their heartbeats before transplanting them into the recipients.

Three patients have undergone transplants with the new technique so far.

Traditionally, donor hearts are taken from brain-dead patients - including stroke or accident victims - whose bodies are still being kept alive by artificial means.

Once removed, such hearts are cooled on ice before being transplanted into the recipients. However, this method has its limitations.

"The heart needs to be transplanted within six hours for it to function well," Prof Lim said.

Around two to four heart transplants take place every year at the NHCS, which is the only place where heart and lung transplants are performed.

But fewer than 60 heart transplants have taken place here since 1990, primarily due to low donor rates.

There are currently 22 end-stage heart failure patients on the waiting list to get a new heart. Typically, such patients wait for about 11/2 years.

"The Australian technique is a major breakthrough," Prof Lim said. "This will allow surgeons to assess the donor heart as it recovers.

"When it has regained normal or close to normal function, it can then be used in a transplant."


This article was first published on Nov 1, 2014.
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