Organ transplants have helped to save the lives of millions of people over the years, giving them a new lease on life that would have otherwise been impossible. Almost since the beginning of organ transplant technology, one of the biggest obstacles has been a lack of viable organs that can be used.

This is largely because, in order to be a good candidate for a transplant, the organ has to still be alive and in good condition. This is why doctors typically can’t take organs from people who are dying of a condition related to old age. Their organs are already likely having problems, so transplanting them into a young patient would not work well.

For organs like kidneys, it is often possible to get a donation from a living person who can survive with just one kidney. For the heart, however, that is not an option. So, people who need a transplant have to wait until someone with a compatible heart dies in such a way that their heart is still healthy, and they are in a hospital at the time of death so that it can be preserved and quickly transported for the transplant surgery.

Needless to say, this does not happen often, which is why so many people die waiting for a donor heart. This issue is compounded further when the person needing a heart is an infant or young child.

Researchers are working on creating artificial hearts in various ways, including mechanical hearts and even potentially using human tissue to 3D print a new heart, but those options are still years away. For now, two new techniques have been successfully tried that could increase the number of hearts viable for donation by 30%, which could save thousands of lives.

Doctors have been able to reanimate a non-beating heart by using a technique known as normothermic regional perfusion (NRP). This is done by restoring blood flow to the heart, triggering the heart to start beating again. This has been done for some time with hearts that are still in the body of the donor, but that raises the ethical questions of whether the person is actually dead if their heart is beating.

In two separate cases, both published in the New England Journal of Medicine, doctors have been able to take a heart from a deceased patient, remove it from their body, and then reanimate it so that it starts beating again. From there, it can be transplanted into a patient, giving them a new opportunity at life.

The first case took place with a donor heart that was removed and then filled with oxygenated blood on the operating table. Once it started beating, it was transplanted into a 3-month-old child, who is now doing well.

The second team used a different approach, where they cooled the donor hearts and infused them with ultra-oxygenated solutions before they were removed from the donor body. This was able to keep the heart viable long enough that they could prep the recipient and transplant it into their body. This technique has been used on several patients, with the author of the research saying:

“In the first three reported cases in which this method was used, the hearts were transplanted successfully with normal biventricular function, no evidence of acute cellular or antibody-mediated rejection, and excellent early postoperative outcomes. No adverse events were reported during the perioperative period. By avoiding the limitations of ex situ perfusion platforms as well as the controversial aspects of thoracoabdominal normothermic regional perfusion, this method of heart recovery offers the possibility of broad application.”

Having the ability to expand the number of organ donations, and especially heart donations, that can be successfully used for transplants will save many thousands of lives in the coming years. While a true long-term solution to the need for new organs is likely to come primarily from 3D printing-type technologies, this is an excellent step forward that can help to bridge the gap until those technologies are perfected.

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