Two years after Europe’s first successful non beating heart transplant, the team at Papworth Hospital say they have proven that heart transplants from circulatory determined dead donors (DCD) are successful and can save many more patients on the ever-growing heart transplant waiting list.
Doctors at the Cambridge hospital were the first in Europe to successfully perform the operation, in March 2015, after identifying the new source of donor hearts. Up until then surgeons were only able to transplant beating hearts from donors following the diagnosis of brain death (DBD).
The heart transplant rate at Papworth has increased by over a third since Huseyin Ulucan from London became the first recipient of a DCD heart, and doctors say the results are comparable to the current standard of hearts transplanted from brain dead donors.
After two years waiting for a transplant on the transplant waiting list, Tom Shing was put on the DCD list and three months later, in April 2015, received the new heart he desperately needed. The agricultural engineer from Hertfordshire was the second patient at Papworth to undergo the procedure and only the seventh in the world.
Tom, now 25, said: “I don’t know whether I would have got a DBD heart – because of the type of match I needed. One of the matches is your height; well I’m 6ft 3ins which eliminated a lot of potential donor hearts. They said it would be very hard to find a donor on the normal list. You also need to find the right blood type – there are a lot of other things on the list.”
He was diagnosed with cardiomyopathy; a disease of the heart muscle which eventually left him fighting for his life in hospital and in need of a heart transplant by his late teens.
“When I was first on the list, I was coping but I was struggling. I was still leading a normal life to an extent. But I couldn’t do any exercise; I couldn’t drink, because it would tire me out. Even walking the dogs, I could only do a mile at the most and then I’d be out of breath and throwing up. Nearer the end it got really bad, if I walked up the stairs to go to the toilet I’d have to take a five-minute break at the top before I came back down.”
Within seven hours of the surgery, the extreme sports lover was out of bed and doing exercises with a physiotherapist. Within 10 weeks he was wakeboarding, and within 12 weeks he was back on his motocross bike.
Tom is now encouraging people to sign up to the NHS Organ Donor Register. He said: “They struggle with donors and people not signing up. So the question is – Would you be willing to take a donor organ for yourself, your husband, wife, son or daughter? If yes, then you should be willing to sign up and put yourself on the organ donor register.”
Cardiothoracic Transplant Registrar Simon Messer, who helped pioneer the DCD procedure, said: “DCD heart transplantation is an amazing development that has saved the lives of dozens of patients dying of end stage heart failure. However, we need more people to sign up to the organ donor register as currently due to severe donor organ shortage, 43 per cent of patients on the elective heart transplant waiting list will either die or deteriorate to the extend that they are permanently removed from the waiting list.”
Other hospitals from across the UK, Europe and Canada are following Papworth’s lead in DCD heart transplantation in order that many more patients can benefit from a heart transplant.
A DCD heart transplant costs around £25,000 more than a DBD procedure, and at present, in the UK, is paid for through fundraising.