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World-first surgery offers new hope to patients as ‘dead hearts’ beat again
25-10-2014, 08:27 AM.
Post: #1
World-first surgery offers new hope to patients as ‘dead hearts’ beat again
World-first surgery offers new hope to patients as ‘dead hearts’ beat again
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John Ross

Higher Education Reporter
Australian heart transplant breakthough

Jan Damen, 43, is recovering in St Vincent's hospital after a revolutionary new type of hJan Damen, 43, is recovering in St Vincent's hospital after a revolutionary new type of heart transplant. Picture: Britta Campion Source: News Corp Australia
Australian heart transplant breakthoughJan Damen, 43, is recovering in St Vince...

MICHELLE Gribilas and Jan Damen have new lives planned following revolutionary heart transplants that offer promise for transplant recipients worldwide. She wants to write a cookbook. He wants to be a screen printer.

“It’s time for a change,” said 43-year-old Mr Damen, a Sydney carpenter until he was diagnosed with post-viral cardiomyopathy a few years ago. “If I can get through this, I can challenge myself to just about anything.”

Mr Damen and Ms Gribilas, a 57-year-old Greek-Australian also from Sydney, received donor hearts that had stopped beating and had then been ­revived and transported to the waiting recipients. A third patient, a man who underwent a similar procedure this week, is also recovering well.

Sydney’s St Vincent’s Hospital, which developed the world-first technique with the Victor Chang Cardiac Research Institute, said it represented a “paradigm shift” in organ donation. Surgeon Kumud Dhital said it meant at least 20 per cent more patients — about 20 Australians a year — could receive new hearts.

For decades, heart donations have been limited to brain-dead patients whose hearts are still beating. This tight availability of donor organs has proven the “biggest hindrance” for St Vincent’s 30-year-old heart transplant unit, medical director Peter MacDonald said. Experiments on animals over the past two decades have shown that it is theoretically possible to revive hearts that have stopped beating for 15 to 20 minutes. But even if the same could be done with human hearts, doctors still faced the challenge of assessing their suitability as donor hearts and preserving them until they reached recipients.

The St Vincent’s team has overcome these challenges with a special preservation solution and a US-developed “heart in a box” system where the heart is reanimated, preserved and assessed. The organ is connected to a sterile circuit where it is kept beating and warm, eliminating some shortcomings of the current technique of chilling the heart on ice.

The team was also able to revive human hearts after more than 30 minutes of “circulatory death”, providing vital extra minutes in which the organs could be extracted and revived. “The whole process becomes one of doing things in a very rapid and technically ­efficient way, to try and guarantee a better heart,” Dr Dhital said.

He said donations would now be possible from people whose ­injuries had not killed all brain function, but who died during treatment, and from brain-dead people whose hearts would previously have been considered ­unsuitable for transplant.

Dr Dhital said researchers were examining new heart repair methods such as regenerative therapy, bio-engineering and mechanical replacement therapies. In the meantime, increasing the donated organ pool was the only way to boost heart transplant numbers.

Mr Damen received his new heart just over two weeks ago. The next morning he already felt “100 per cent better”.

The Narrabeen father of three said he expected to be out of hospital next week. “I’m chomping at the bit to get back into life and do things with the family again.”

Ms Gribilas said she had completely recovered after her July operation, and planned to ask the Red Cross to pass a letter of thanks to her donor’s family. “I cry for the person who passed away,” she said. “But out of the organs you give from your son, daughter, mother or father, 18 people can survive.”

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