In Canada's first breakthrough, surgeons at the University of Toronto Health Network (UHN) have successfully performed a heart transplant using a donor whose heart has stopped. This is a procedure known as cardiovascular postmortem donation.
Unlike traditional heart transplants, which use organs from brain-dead donors whose hearts continue to beat, this new approach recovers the heart after life support is removed and the heart stops beating.
In early September, a team at UHN Toronto General Hospital transplanted a heart that stopped beating after life support was removed.
“Previously, we only used hearts from brain-dead donors whose hearts were still beating. Now we can use hearts that have stopped beating after life support is removed,” said Dr. Ali Rabi, a cardiac surgeon at UHN Peter Munk Heart Center who led the operation.
This new method allows doctors to perform the same surgery on more viable donors, increasing the number of hearts available.
“These are donors who are not considered brain dead. They have some basic reflexes, but there is no hope of recovery. That decision is made by the patient, their family, the treatment team, the neurology team. Then the family decides they don't want their loved one to continue in this situation.”
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This revolutionary step in the world of organ transplants marks a turning point for people waiting for a new heart.
Heart failure is one of the most common reasons for hospitalization and the leading cause of death in Canada.
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According to the Canadian Institute for Health Information, 155 adults and 29 children will be waiting for a heart transplant by the end of 2024.
“Thanks to this procedure, the number of heart transplants will increase by 20 to 40 percent. This will also reduce the number of people who do not receive a heart transplant and die while waiting for a heart transplant,” Ravi said.
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The technology has also been successfully used in other countries, including Australia, the UK and the US. In Canada, this method is expected to increase heart transplants by about 30%.
“When the new patient's heart started beating again, it was amazing. The natural strength of the heart is incredible.”
Sylvia Jones, Ontario's deputy premier and minister of health, praised the accomplishment in a release posted by UHN. “This breakthrough shows how innovation can save more lives. Congratulations to UHN on achieving this historic milestone,” she said.
Ravi also acknowledged the generosity of donor families, saying, “This is the most difficult day of their lives, but many take comfort in knowing that their loved one saved another.”
Dr Ravi said recent data from Australia and the US show no difference in long-term survival between recipients of DCC (post-circulatory death donor) hearts and recipients of hearts from traditional brain-dead donors.
“I encourage young people interested in heart failure and heart transplantation to look into this field. I guarantee you that within the next five years, this field will not be recognized at all,” he added.
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