Express delivery mends broken hearts in scientific first

A team of Australian surgeons and engineers is to begin a groundbreaking project giving the kiss of life to dead human hearts.

Intensive care surgeon John Fraser and heart transplant recipient Kate Phillips.

This Valentine’s Day, as romantics across the world share kisses and candy hearts, a team of Australian surgeons and engineers will begin a groundbreaking project giving the kiss of life to dead human hearts, revolutionising the national viability of donor hearts.

Altogether, 381 hearts were available in Australia for organ transplantation last year, but only 81 heart transplants were performed ­because of the viability of donor hearts that deteriorate rapidly while being transported vast distances across the country in backyard iceboxes.

Equal parts forefront science and Frankenstein fantasy, the joint research effort by Brisbane’s Prince Charles, Sydney’s St Vincent’s and Melbourne’s Alfred hospitals, in collaboration with Swedish engineers, will see ­donor hearts placed in a transportable device called an ex vivo machine, worth $250,000, that uses a “physiologically composed medical fluid” to “reboot” the dead organ with a constant supply of oxygen for up to 24 hours, increasing the number of viable transplant hearts by up to 40 per cent.

“It’s Gatorade for hearts,” said professor John Fraser from the Prince Charles Hospital critical care research group. “The fluid mixes the donor’s blood, which has beautifully evolved over millions of years, with various solutions of minerals, nutrients and the right balance of salt. We’re still transporting it in a box but the box is perfused, there’s a continuous flow of liquid within it, and that blood and that solution is being continually oxygenated, feeding all the right stuff, the right Gator­ade, to the heart.”

To use a more timely analogy, Professor Fraser said, “feeding the roses so they can stay alive and make it to your house on Valentine’s Day”.

Three years ago, Kate Phillips, 30, spent three months in hospital on a national emergency register before receiving a heart and double­ lung transplant.

“You’re in that situation and you’re deteriorating, but you want to live so bad,” she said. “You ­realise very quickly just what an incredible gift these organs are.”

Last year, Ms Phillips com­pleted the Noosa Triathlon. This June, she will compete in her first Iron Woman event. “You hear of people wheeled into theatre and then they’re told, ‘No, sorry, something’s happened to the organ along the way’. A 24-hour window to transport an organ? That’s game-changing,” she said.

Professor Fraser said donor hearts were lucky to withstand a transport time of roughly four hours, with only one in four reaching operating theatres.

Funded through the Prince Charles Hospital Foundation’s Common Good initiative, in which everyday Australians fund research by buying chunks of time — a $44 ­donation equals one hour of ­funded research — the project could mean not only more durable hearts during transport but better and longer lives for ­recipients.

“In terms of organ preserv­ation, there’s been relatively little to improve things over the last 20 or 30 years,” Professor Fraser said. “Pretty much you put an organ in a bag of ice and run really fast. In a country as vast as Australia, time is of the essence. This technology could mean where we might once have given someone a heart that allows them to walk around Coles for a while, maybe we can give someone a heart that allows them to see their daughter graduate 10, 20 years from now.”

Michael Hornby, chief executive of the Prince Charles Hospital Foundation, said the project was an example of the public funding solutions to their own medical problems. “The only way this stuff can occur is by ordinary Australians getting behind it,” he said. “They’re not giving to a charity, they’re giving to a health outcome.

“This is the only ex vivo ­machine in Australia and on Sunday­, when we start, it will be the first time it’ll be used.

“The machine will be the centrepiece of all the ­research.”