New Machine Keeps 'Heart in a Box' Beating Macabre, yes, but this advance could bring longer life to donated organs.
by Arthur L. Caplan
One of the greatest short stories ever written
is Edgar Allan Poe’s “The Tell-Tale Heart.” In this 1843 classic, the
murderer of an old man is tortured by the sound of his victim's heart
continuing to beat, a sound which no one else seems to hear. The
relentless beating eventually leads the murderer to confess. That
creepy tale certainly kept a 10-year-old Arthur Caplan awake at night.Now
there's a machine that can do what Poe imagined — preserve a beating
heart in isolation. And while this might seem to be the yuckiest idea
to come down the pike in a long time, it really represents a bold and
fascinating advance in trying to save the lives of people with failing
hearts. The “heart in a box” machine, known as the
Organ Care System, is made by TransMedics Inc., of Andover, Mass.
Doctors in Pittsburgh recently announced that they used the machine to
keep hearts beating for hours on their own after being removed from
cadavers. Three patients, a 47-year-old man and two women in their 50s,
received these hearts and all seem to be doing very well. The
machine will be tested further in the coming year at five transplant
centers in the U.S. — the University of Pittsburgh Medical Center,
Brigham and Women's Hospital in Boston, UCLA Medical Center in Los
Angeles, the University of Chicago Hospitals' Cardiac Center and the
Cleveland Clinic. The researchers want to be sure that hearts
transplanted out of the box really work as well as those preserved by
current methods. Until
now, when a heart was donated upon someone’s death, the organ was
saturated with preservative fluid and stashed in a thermos-type cooler
packed with ice. We’ve all seen the images of people in white coats
running to or from airplanes, cooler in hand, racing against the clock
to get an organ to someone in desperate need. Hearts are very fragile and can sometimes be damaged by the current standard method of preserving them on ice. Inside
the new transportable box, a machine pumps blood donor through the
heart without requiring cold temperatures or artificial preservative
fluids. The company says a heart kept functioning this way can be
preserved for at least 24 hours.
If this machine succeeds in keeping hearts beating safely in more
trials, then instead of the current six-hour limit that existing
preservation techniques allow, hearts could be moved anywhere in the
country to where someone needs one without worrying about how long the
process is taking. And some hearts that might not be strong enough to
last using current techniques might be able to be salvaged and
transplanted using this new technology. There is no denying that, as Poe understood,
the image of the beating heart outside the body is macabre. That is
until you imagine a family grieving over the loss of a loved one
because there was no heart to transplant. That truly nightmarish image
is the one this new machine may help prevent.
Posted: 2007-05-21 |