Surgeons show heart with Asian transplant first

Local | Maisy Mok 7 May 2020

Queen Mary Hospital has successfully performed a heart transplant from a "marginal" braindead heart donor by using a system that can facilitate such operation - a first in Asia.

The operation may help to shorten the long waiting list of heart transplant patients, which went up from five in 2009 to 54 in 2019, according to Cally Ho Ka-lai, a consultant at the hospital's department of cardiothoracic surgery.

Ho said only eight heart transplant procedures were performed in Hong Kong last year - the lowest in five years - due to a lack of suitable donors.

The hospital hopes to increase the number by three to five cases a year with the introduction of the medical device, the Organ Care System, which would allow doctors to use hearts donated by "marginal" donors.

"Marginal heart donors refer to donors who do not meet a few of the conventional standard criteria for donation of organs. With the availability of this new technology doctors could perfuse the heart out of the donor’s body in the Organ Care System, conduct a few tests, assess its function and then decide whether or not it would be suitable to transplant into the recipient," said chief of service Timmy Au Wing-kuk.

The heart donor in this case was a patient who had died of a stroke.

The donor had met some of the international criteria of being a marginal heart donor, which includes being older than 55 years and having coronary artery disease with stenosis higher than 50 percent.

The recipient was a female in her 50s, who was diagnosed with bi-ventricular heart failure in 2016, and whose heart function worsened in March 2020.

Before the operation, she had to rely on double inotropes - medication that strengthens the heart - to keep her alive.

The operation took 14 hours and the donated heart was kept in the OCS for four hours and 16 minutes.

The OCS is a blood perfusing medical device that can maintain out-of-body organs in near-physiological conditions. The heart continues to beat in the storage system, and it is kept at 34 degrees Celsius.

Other functions, including assessing the donor's organs and optimizing organ condition through infusing medication, can also be done through the device.

The recipient was able to walk four days after the operation, and is recovering at Grantham Hospital.

"Her heart function is good and shows vital signs . . . it is expected she will be discharged in mid-May," Au said.

Care for Your Heart, a local charitable organization, has donated five OCS machines to the hospital.

Queen Mary Hospital hopes to use the machine to store and transport other organs, such as the liver and kidneys and conduct long-distance organ transportation between nearby Asian regions.

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