heart transplant Archives - Amazing Health Advances

Alternatives to Heart Transplant? You Have Options

The AHA! Team — Wed, 02 Jul 2025 05:53:37 +0000

Morgan deBlecourt via Duke Health – “The good news is there are new therapies coming out every day,” said Dr. DeVore. “We can help find the option that’s right for you.” Heart transplantation can be a life-saving treatment for severe heart failure, but it’s a serious operation that requires a lifelong commitment. As a result, a heart transplant is not the best option for everyone. Fortunately, there are alternatives. “There are new therapies coming out every day,” said Adam DeVore, MD, a Duke transplant cardiologist and heart failure specialist. These new therapies can improve or help take over the heart’s function and prolong life. What Does A Heart Transplant Require? Most people who are eligible for a heart transplant have significant heart failure — a chronic condition in which your heart has trouble pumping blood — or another severe type of heart disease that could lead to death within one year. You may not be eligible for heart transplantation if you are over 70 years old or have other major health problems. Taking care of your new heart after transplant is a lifelong effort. For this reason, a heart transplant requires certain commitments, including abstaining from tobacco and illegal substances and limiting alcohol, attending frequent follow-up appointments, and taking anti-rejection and other medications. People who get a heart transplant need a strong support network, not only to help with recovery after the transplant surgery itself, but also to help coordinate appointments and long-term medications. If you aren’t eligible or if now is not the right time for heart transplantation, one of several alternatives may fit your needs. Ventricular Assist Devices Implantable left ventricular assist devices (also called VADs or LVADs) are mechanical pumps that help your heart supply blood to the rest of the body. They can extend a person’s life for years, either as they await transplant or as a definitive therapy in itself. LVADs have internal and external components. The pump is inserted into the heart during surgery. It takes blood from the left ventricle, the largest chamber of the heart that is most often weakened in people with heart failure, and pumps it directly into the aorta toward the rest of the body. The pump is connected to a controller outside of your body by a thin cord that exits through a small incision in the abdomen. Battery packs attach to the controller to power the device. Together the controller and battery packs weigh about five pounds. Living with a VAD takes some getting used to. You’ll need to always have a reliable power source available. You’ll also need to keep an eye out for infection. And although you can shower, you won’t be able to swim or take a bath, since the device can’t be submerged. Smaller LVADs Although LVADs are often used as a “bridge” to heart transplantation (meaning it supports the rest of your body while you wait for a heart transplant), advances in technology have made LVADs smaller, more portable, and more viable as a final treatment; doctors sometimes refer to this as “destination therapy.” Depending on the severity of heart failure, most people with an LVAD are able to get back to living life pretty close to normal. “Duke has been a pioneer in LVAD therapy. We have constantly worked to understand how to best care for these patients as the pumps have become more durable, smaller, and easier to implant, which all results in making it easier to have a normal life. We’re continuing to push the envelope from a technological perspective as well as a best-practice perspective,” said Duke advanced heart failure specialist and transplant cardiologist Stu Russell, MD. Artificial Heart Duke recently became the second center in the world to successfully implant a new form of mechanical heart pump known as the BiVACOR Total Artificial Heart (TAH). For people with heart failure of both the left and right sides of the heart, this device provides complete blood circulation for the entire body. Currently, the BiVACOR total artificial heart is only available as a temporary stabilizing option for people awaiting heart transplant surgery. However, pumps like these may also eventually serve as a permanent solution, similar to current LVAD treatments. Other Surgical Options for Heart Failure According to Dr. Adam DeVore, “heart failure” is an umbrella term for several heart conditions that lead to the heart failing. Depending on the underlying cause of your heart failure, surgery may be an option. For example, heart failure caused by coronary artery disease may benefit from coronary artery bypass graft (CABG) surgery. It reroutes your heart’s blood flow around a blocked, damaged, or narrowed blood vessel. Damaged or diseased heart valves can be treated with valve surgery to improve the heart’s ability to move blood properly. Ultimately, these operations may not cure your heart disease, and you might still need an LVAD or heart transplant later. Heart Failure Medical Management Whether you have a transplant, get an LVAD, or undergo a different kind of heart surgery, you’ll still need to make lifestyle changes (healthy eating, exercise, etc.) and take medications that help slow your heart disease and reduce its symptoms. “The good news is there are new therapies coming out every day,” said Dr. DeVore. “We can help find the option that’s right for you.” To read the original article click here.

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Antibody Shows Promise for Preventing Organ Rejection After Transplantation

The AHA! Team — Wed, 12 Jun 2024 04:30:14 +0000

Duke Health – DURHAM, N.C. – A man-made antibody successfully prevented organ rejection when tested in primates that had undergone a kidney transplant, Duke Health researchers report. The finding clears the way for the new monoclonal antibody to move forward in human clinical trials. Results of the study appear online Aug. 30 in the journal Science Translational Medicine. “Current medications to prevent organ rejection are good overall, but they have a lot of side effects,” said lead author Imran J. Anwar, M.D., a surgical research fellow in Duke’s Department of Surgery. “These therapies suppress the immune system, putting patients at risk of infections and organ damage, and many cause non-immune complications such as diabetes and high blood pressure. “The push over the last decades has been to develop new, less toxic drugs,” Anwar said. “We are hopeful this antibody moves us closer to that goal.” Anwar and colleagues, including co-senior author Allan Kirk, M.D., Ph.D., chair of the Department of Surgery, focused on a monoclonal antibody identified as AT-1501. It was engineered to minimize the risk of blood clots, which had become problematic for an earlier version of this therapy. In studies using primates that had undergone kidney transplantation, AT-1501 prevented rejection without the need for additional immunosuppressive drugs or promoting blood clots, confirming its immunosuppressive potential. In animals that had undergone islet transplantation, AT-1501 alone did not lead to uniform rejection control, but it was effective in combination with existing immunosuppressive agents. The combination therapies in islet transplantation led to uniform islet graft survival without weight loss or infections that can typically arise. The islet transplants were performed by Norma Kenyon, Ph.D., co-senior author and professor at the University of Miami. “These data support AT-1501 as a safe and effective agent to promote both islet and kidney transplant survival and function and allow us to advance into clinical trials right away,” Kirk said. “This less toxic approach has been pursued for over 20 years, and I think we are finally at a turning point. This could be a great advance for people in need of organ transplants.” In addition to Kirk and Anwar, study authors include Dora M. Berman, Isabel DeLaura, Qimeng Gao, Melissa A. Willman, Allison Miller, Alan Gill, Cindy Gill, Steve Perrin, Camillo Ricordi, Philip Ruiz, Mingqing Song, Joseph M Ladowski, and Norma S. Kenyon. The study received funding support from the National Institutes of Health (U19-AI051731), the Diabetes Research Institute Foundation, and Anelixis Therapeutics, now Eledon Pharmaceuticals, which is developing AT-1501 for kidney and islet cell transplant. To read the original article click here.

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World’s First Partial Heart Transplant Proves Successful in First Year

The AHA! Team — Wed, 29 May 2024 08:13:15 +0000

Journal of the American Medical Assocation via Duke Health – Novel procedure demonstrated valve growth & functionality in newly published study results The world’s first partial heart transplant has achieved what researchers have spent more than a year hoping for DURHAM, N.C. – The world’s first partial heart transplant has achieved what researchers have spent more than a year hoping for — functioning valves and arteries that grow along with the young patient, as hypothesized by the pioneering team behind the procedure at Duke Health. The procedure was performed in the spring of 2022, in an infant who needed heart valve replacement. The previous standard of care — using valves that were non-living — would not grow along with the child, requiring frequent replacement, entailing surgical procedures that carry a 50% mortality rate. A study led by Duke Health physicians, appearing online Jan. 2 in the Journal of the American Medical Association, found that the new manner of valve procurement used during the partial heart transplant led to two well-functioning valves and arteries that are growing in concert with the child as if they were native vessels. “This publication is proof that this technology works, this idea works, and can be used to help other children,” said Joseph W. Turek, M.D., Ph.D., first author of the study and Duke’s chief of pediatric cardiac surgery, who led the landmark procedure. The study also found the procedure requires about a quarter of the amount of immunosuppressant medication than a full heart transplant, potentially saving patients from detrimental side effects that might compound over decades. Turek said the innovation has paved the way for a domino heart transplant, where one heart is able to save two lives. During a domino heart transplant, a patient who has healthy valves but is in need of stronger heart muscle receives a full heart transplant; their healthy valves are then donated to another patient in need, creating a domino effect. “You could potentially double the number of hearts that are used for the benefit of children with heart disease,” Turek said. “Of all the hearts that are donated, roughly half meet the criteria to go on to be used for full transplant, but we believe there’s an equal number of hearts that could be used for valves.” You could potentially double the number of hearts that are used for the benefit of children with heart disease “If you introduce the donated hearts that weren’t being put to use into the supply chain and add the valves from domino heart transplants, that can create a substantial change,” Turek said. The partial heart transplant procedure has been performed 13 times at four centers around the world, including nine at Duke, several of which have been domino heart transplants. Turek said bringing this innovation to a clinical trial would be the next step to achieving the volume in procedures that would change the availability of hearts by a large amount. “This innovation adds a lot to the whole donation community,” Turek said, “because it’s treating more kids, while also honoring the wishes of selfless donor parents who’ve given the ultimate gift. It allows them to offer hope to another child in the process.” Preclinical data was supported by the Brett Boyer Foundation. In addition to Turek, study authors include Lillian Kang, Douglas Overbey, Michael P. Carboni, and Taufiek K. Rajab. To read the original article click here.

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First Pig-to-Human Heart Transplant: Genetically Modified Animal Organs Could One Day End Donor Organ Waiting Lists

AHA Publisher — Fri, 14 Jan 2022 08:00:36 +0000

University of California San Diego Health via Newswise – The first pig-to-human heart transplant, reported yesterday in the New York Times, is a watershed moment in medicine that may pave the way to using animal organs for human transplantation. Performed January 7, 2022 at University of Maryland School of Medicine, the eight-hour surgery placed a genetically modified pig’s heart into the chest cavity of a 57-year-old man with life-threatening heart disease. The heart was modified to resist rejection by the human immune system. The medical achievement offers hope to hundreds of thousands of patients with failing organs, of which approximately a dozen die on waiting lists every day. (Though 3,817 Americans received human donor hearts last year — more than 80 at UC San Diego Health alone — demand greatly exceeds supply.) To read the original article click here.

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Novel Transplant Technique Revives Donor Hearts That Had Stopped Beating

AHA Publisher — Mon, 02 Mar 2020 08:00:26 +0000

Vanderbilt University Medical Center via Newswise – In the first such procedures in Tennessee, Vanderbilt University Medical Center has successfully used technology to bring two donor hearts that stopped beating back to life before transplanting them into patients. Newswise — Until recently, such hearts, categorized as donation after cardiac death (DCD), could not be used for transplant and were discarded. VUMC’s Cardiac Surgery team used a warm blood perfusion system to reanimate the hearts before transplanting them into patients over the last month, joining only a handful of such transplants performed nationwide. VUMC is among five centers participating in a recently launched clinical trial to transplant the DCD hearts. Using DCD hearts has the potential to greatly expand the number of hearts available, providing more life-saving transplants for VUMC patients and shortening wait times for people badly in need of a transplant. The risk of dying on the waiting list is at least 10% and death rates increase the longer a patient has to wait. “It is a new frontier in heart transplantation,” said Ashish Shah, MD, professor and chair of Cardiac Surgery. “Although this has been done for other organs like lung, liver and kidney, it has really never been done before in the United States on hearts in this manner until very recently. The idea of machine perfusion really is groundbreaking and could potentially change the field in several ways.” In addition to expanding the donor organ pool, Shah said the DCD transplants will help doctors gain a better understanding about how hearts work when injured and how they can be restored. “How do you repair hearts so that we don’t need transplant?” he said. DCD heart transplants are very different than conventional procedures. In a traditional heart transplant, a brain-dead donor is brought to the operating room in a well-planned process. Doctors infuse a preservation solution into the heart and other organs before it is removed, placed on ice and delivered it for transplant. Such a process takes 20 to 30 minutes, plus what can be hours of travel time before the heart can reach its destination. A DCD transplant is far more complex, Shah said. In a DCD transplant, donors are not officially brain dead, so they are taken to the operating room where the heart naturally stops. Once the patient is declared dead, surgeons race to open the chest, insert tubes to infuse the preservation solution and then remove the heart— all within 20 minutes. From there the team re-animates the heart on the perfusion system to determine if it is usable. “It can take several hours and a fair amount of delicate manipulation, but ultimately we believe these will be healthy hearts that can save someone’s life,” Shah said. Vanderbilt’s surgical teams for the first DCD heart transplants included surgeons Shah, Keki Balsara, MD, and William McMaster, MD; and perfusionists Matthew Warhoover, MS, CCP, LCP, and Harry Moneypenny, BS, CCP, LCP. No other transplant center in the nation transplants more hearts than VUMC, which performed a record 118 transplants last year. The Vanderbilt Transplant Center is the South’s premier transplant center, providing more opportunity for patients to participate in clinical trials that help advance the science of organ transplantation, as well as access to other specialists. Its transplant teams have performed more than 9,500 solid organ transplants since 1962, including all major organs — heart, kidney, lung, liver and pancreas. To read the original article click here.

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Robotic Heart to Replace Human Transplants on the Horizon

AHA Publisher — Fri, 07 Feb 2020 08:00:37 +0000

Dr. Liji Thomas, MD via News-Medical Net – Scientists are working to end the need for human heart transplants by 2028. A team of researchers in the UK, Cambridge, and the Netherlands are developing a robot heart that can pump blood through the circulatory network but is soft and pliable. The first working model should be ready for implantation into animals within the next 3 years, and into humans within the next 8 years. The device is so promising that it is among just 4 projects that have made it to the shortlist for a £30-million prize, called the Big Beat Challenge for a therapy that can change the game in the treatment of heart disease. The other projects include a genetic therapy for heart defects, a vaccine against heart disease, and wearable technology for early preclinical detection of heart attacks and strokes. The Need There are about 7 million patients with heart and circulatory issues in the UK of which over 150,000 die every year. About 200 heart transplants occur each year in the UK alone, yet about 20 patients die in the same period while waiting for one. This is especially true if the patient waiting for one is a baby who was born with a defective heart, since babies need to have hearts transplanted from other babies – who must have died. And even with a successful transplant, strong immunosuppressive drugs must be started and often continued lifelong so that immune rejection does not occur. This is, however, accompanied by a higher risk of infectious and other complications. The Concept The idea was sparked by seeing the picture of the soft but flexible and tough arms of a robot starfish that moved in a manner similar to a real live starfish, says lead researcher Jolanda Kluin. She describes her “Aha!” moment. “Suddenly I saw the potential for merging the benefits of biology with power of soft robotics, for a hybrid heart, the first ever solution for end stage heart failure. Soft robotic artificial cardiac muscles precisely mimic the human heart, so the hybrid heart really beats like a real heart. And it is lined by the patient’s own cells preventing clotting, infection and reaction. The energy transfer is wireless so that the patient experiences real freedom.” The Hybrid Heart This device, called a hybrid heart, has several layers: a synthetic soft artificial muscle layer, that is strong and flexible enough to contract and expand like the heart muscle, an innermost lining layer that can capture specific cells to then slowly build tissue to cover itself, and an outer net-like scaffolding layer covered by the patient’s own cells to reduce the chances of immune rejection of the robotic heart. The battery is in the vest or jacket, but the patient also has an extra smaller battery that can keep the heart going for a brief scheduled period if the patient has a shower or a swim, keeping the jacket aside for an hour or two. The hybrid heart is being patented now in three different models, one of silicone and the other two of soft but non-stretchy materials. The other option that would really offer a really radical opportunity would be to build a living functioning heart from the cells of the patient. This will take decades, she says, even if it ever happens. The previous attempt to build an artificial heart from polyurethane and bovine heart cells was carried out in France, and the 76-year-old man died shortly thereafter, in 2014. The hybrid heart uses stiffer but still very flexible material to mimic the heart’s natural movement and pumping action. She says, “While radical, our ambition is not science fiction. What people with heart failure can dream, hybrid hearts can achieve.”The team have already received £50,000 to fund the initial development of their projected devices over the next 6 months. Sir Nilesh Samani of the British Heart Foundation (BHF) comments on the Big Beat Challenge: “Heart and circulatory diseases remain the number one cause of death worldwide. We’re taking small steps forward every year but what’s needed is a giant leap, which won’t be achieved by a business-as-usual approach. This represents the single biggest investment in pioneering science in the BHF’s 60-year history.” To read the original article click here.

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Massachusetts Surgeons Perform First-of-Its-Kind Heart Transplant in New England

AHA Publisher — Sun, 12 Jan 2020 08:00:29 +0000

Massachusetts General Hospital via News-Medical Net – A team of surgeons and specialists at Massachusetts General Hospital (MGH) is announcing an achievement in transplant surgery today, having recently performed the largest number of adult heart transplants in the country using what are known as Donation after Circulatory Death (DCD) donor hearts. The five transplants also include the first surgery of this kind for the New England region. For decades, heart transplant cases in the U.S. have been dependent solely upon organs donated after brain death or irreversible loss of brain function. A DCD donor has brain function incompatible with life, but doesn’t meet all criteria for brain death. Life support is removed and if the donor’s heart stops beating within a certain window of time, death is declared and the organ is removed. Outside the body, blood circulation is re-established in the heart using a machine pump while it is being transferred to the recipient. “This is a significant moment not only for MGH, but hopefully for transplant centers around the the country. Patients die each day while waiting for transplants, due to a major shortage of suitable organs. This is one way we can work toward addressing that gap.” David D’Alessandro, MD, surgical director for Heart Transplantation at MGH The first adult DCD heart transplant in the U.S. was performed at Duke University Hospital last month. Duke and MGH are among five centers taking part in a clinical trial for DCD heart transplants, involving the use of the Organ Care System (OCS) designed by Massachusetts-based Transmedics. The portable OCS, often referred to as “heart in a box,” restores the donor organ with warm, oxygenated blood, re-animating it until it can be safely transplanted. OCS was also used during the world’s first DCD heart transplant in Australia in 2014 and in England’s first DCD heart transplant in 2015. “Recent studies have shown outcomes among DCD heart transplant patients overseas have been favorable,” said James Markmann, MD, PhD, chief of the Division of Transplant Surgery at MGH. “I’m confident we will continue to see this program grow at MGH.” The DCD heart transplant trial is expected to run through August of 2021. To read the original article click here.

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