‘Heart-in-a-box’ device revives dead hearts for transplant

It could increase the amount of donated hearts by up to 30 percent.

Researchers in the US have developed a device that can bring a dead heart back to life, even after it’s stopped beating inside its original body. And while this is great news for those in need of a heart transplant, it’s already raising big ethical questions over how we can proclaim a person “dead” if we can restart their heart in someone else’s body.

“How can you say it’s irreversible, when the circulatory function is restored in a different body? We tend to overlook that because we want to transplant these organs,” Robert Truog, a medical ethicist at Harvard University in the US, told Antonio Regalado at MIT Technology Review

Right now, if you need a heart transplant, you’re going to have to wait for the family of a vegetative patient to sign one over to you, because transplanting a heart from a deceased person is considered too risky. Hearts from vegetative patients, on the other hand, can be cooled down inside the body when the person is still alive, gently stopped, extracted, and transported in a container at around 4°C.

Cooling it down this much means the heart’s metabolic activity will be cut by up to 90 percent, which gives doctors enough time to stitch it up inside someone else and get it beating again before it runs out of oxygen. About 180 hearts are made available for transplant in the US each year using this technique, but that’s no where near meeting demand. “In the US about 2,400 heart transplants occur each year, a figure that has remained essentially unchanged for 20 years,” Regalado reports.

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Developed by Massachusetts-based company, Transmedics, the new heart-in-a-box device works by keeping the extracted heart warm, not cool. The heart is transferred to a sterile chamber fitted on a wheeled cart, inside which tubing is clamped onto the organ to give it a constant supply of oxygen, blood, and nutrients. The team behind the design says this will likely prolong the amount of time a heart can be kept functional outside a body.

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