Heart failure continues to be an epidemic in the U.S. Despite efforts put into awareness and prevention, heart disease is the leading cause of death for both men and women. A heart transplant is the gold standard to treat advanced heart failure. With more than 100,000 people on the transplant waiting list, Mayo Clinic is hoping to save more lives by adopting strategies for expanding the donor pool for heart transplants.
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On average, 17 people die each day waiting for a transplant, which is why expanding the donor pool has never been more important.
Traditionally, donor hearts were retrieved from patients who were declared brain dead, but their heart remained beating.
However, game-changing organ perfusion systems, such as "heart in a box," have allowed for increased use of donation after circulatory death, where the heart stops beating.
"Donors (from) circulatory death, their heart has stopped, there is a five-minute waiting period, a declaration of their death, and then we take the heart out and put it in a box and perfuse it over there," says Dr. Mauricio Villavicencio, a Mayo Clinic heart and lung transplant surgeon.
Once the heart is reanimated, the function of the organ is assessed for transplant. The system allows the organ to stay warm and metabolically active, extending the time between retrieval and transplant by several hours.
"We have had three, four, five, six hours of perfusion on the device," says Dr. Villavicencio. "If you have four hours, you could go essentially around all North America with that."
Something else that's helping to expand donor pools is the new generation of antivirals that allow for the safe transplantation of organs from hepatitis C-positive donors. A significant source of donor organs that, before, would have been discarded.