Heart-In-A-Box Saves Organ For Later

The "heart-in-a-box" device was developed by Transmedics, an Andover, Massachusetts-based company, and is pending approval in the U.S. It consists of a sterile chamber and tubing to clamp onto a donor heart keeping it nice and fresh for transplantation.


(Heart in a box

Earlier this year, in the Lancet, surgeons at St. Vincent’s Hospital in New South Wales described three cases in which they waited as little as two minutes after a person’s heart stopped before they began removing it. Within 20 minutes, they’d attached it to the Transmedics rig, where it began beating again after being fed with oxygenated blood and electrolytes. Without such help, surgeons consider hearts from dead donors too damaged to use. “The device is vital. The heart gets an absolutely essential infusion of blood to restore its energy,” says Stephen Large, a surgeon at Papworth Hospital in the United Kingdom, which has used the system as part of eight heart transplants.

The heart in a box is part of a wider shift away from shipping organs cold to keeping them warm and functioning. In recent tests of such techniques, called warm perfusion, scientists have shown they can cut off a pig’s leg then replace it 12 hours later if it receives a supply of nutrients.

“Cold is the old thing, and warm is the new thing,” says Korkut Uygun, a transplant surgeon at the Massachusetts General Hospital. “Warm is the way to go with metabolically active tissue.”

Long-time readers of science fiction writer Larry Niven know of a way to increase the pool of available organs by an order of magnitude - organlegging.

His heart went into storage immediately. His skin followed, most of it in one piece, all of it still living. The doctor took him apart with exquisite care, like disassembling a flexible, fragile, tremendously complex jigsaw puzzle. The brain was flashburned and the ashes saved for urn burial; but all the rest of the body, in slabs and small blobs and parchment-thin layers and lengths of tubing, went into storage in the hospital's organ banks. Any one of these units could be packed in a travel case at a moment's notice and flown to anywhere in the world in not much more than an hour...
(Read more about organlegging)

Niven gets the early bird award for this one - the text is from his 1967 story The Jigsaw Man. If you think that the illegal harvesting of human organs for transplant can't possibly be a problem, read Real Organleggers: Human Organ Trafficking.

Via Technology Review.

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