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Harefield Hospital experts use pioneering technology to transplant non-beating hearts

7 August 2015

More patients in desperate need of a heart transplant will undergo the life-saving procedure at Harefield Hospital, after a revolutionary new technique known as a non-beating heart transplant was carried out for the first time.
Until very recently, all donated hearts in the UK were from donors declared brain dead, but who still had blood pumping around their bodies. However, a pioneering new method of organ retrieval, which has so far only been carried out a small number of times in the UK, means surgeons can now also consider hearts for transplantation from donors whose hearts have stopped beating, in what is known as circulatory death. This is when both the heart and lungs have stopped working.
Previously an organ donor who had succumbed to circulatory death could donate some other organs, such as the kidney and liver, but not the heart. In order for the heart of a donor who has died a circulatory death to be suitable for transplantation, it must be resuscitated by pumping warm oxygenated blood through the heart muscle. The transplant team at Harefield Hospital has achieved this by using organ retrieval technology, known as the Organ Care System (OCS).
The OCS, sometimes referred to as "heart in a box", allows doctors to maintain and assess organ function and suitability for transplantation.
According to specialist transplant clinicians at Harefield Hospital, the new development has the potential to increase heart transplantation by around 30 per cent in the UK. At present, Harefield and Papworth Hospital in Cambridge are the only transplant centres in the UK to carry out non-beating heart transplants from this group of donors.
Lee Hall, from Illogan, Cornwall, was one of the first patients at Harefield Hospital to receive a heart from a circulatory death donor.
The 26-year-old, who lives with his wife Danyelle and their one-year-old son Hayden, developed heart failure at 14. The condition was linked to chemotherapy he had as a small child to treat leukaemia. Initially, drugs improved his heart’s function, but aged 20 he had become frequently breathless and tired while working as an electrician. He was referred to Harefield Hospital and fitted with a left ventricular assist device (LVAD), a mechanical heart pump often used to keep patients alive and enable them to leave hospital while they wait for a transplant.
Lee remained in relatively good health for five years. However, earlier this year he was put on the urgent transplant list as his health deteriorated, and was asked if he would be happy to receive a non-beating heart.
He explained:
“I had previously read about this type of donated heart online so I was very happy to have one. A couple of days later a suitable non-beating heart became available and I had the transplant.
“I’m grateful that I’ve been cared for at Harefield where this type of heart transplant is possible – without it I’d probably still be waiting for a new heart.
“It is hard to accept that someone has died for you to carry on living and I’d like to thank my donor and their family for making this possible.”
Lee was discharged in July after a successful recovery.
Mr André Simon, director of transplantation at Royal Brompton & Harefield NHS Foundation Trust, said:
“The use of non-beating hearts in transplantation is a very exciting development that will ultimately help us save more lives. It provides new hope to patients who are desperately waiting for a heart transplant.
“We have pioneered the use of the Organ Care System for heart transplantation in the UK in recent years, which has resulted in more patients having life-saving transplants.”

To help the Trust extend its transplant programme into this new area of transplanting non-beating donor hearts, the team at Harefield Hospital has invested in a second OCS machine to ensure patients can benefit from the increased number of donor hearts that will now be available for transplantation. The new system was funded by money raised at a charity concert earlier this year.

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