Researchers try new ways of preserving more hearts for transplants
Two university hospitals are pioneering new ways to expand lifesaving heart transplants for adults and babies — advances that could help recover would-be heart donations that too often go unused.
The new research aims to overcome barriers for using organs from someone who dies when their heart stops. Called DCD, or donation after circulatory death, it involves a controversial recovery technique or the use of expensive machines.
Surgeons at Duke and Vanderbilt universities reported Wednesday that they've separately devised simpler approaches to retrieve those hearts. In the New England Journal of Medicine, they described successfully transplanting hearts to a 3-month-old infant at Duke and three men at Vanderbilt.
"These DCD hearts work just as well as hearts from brain-dead donors," said Vanderbilt lead author Dr. Aaron M. Williams.
How hearts are saved for donation
Most transplanted hearts come from donors who are brain dead. In those situations, the body is left on a ventilator that keeps the heart beating until the organs are removed.
Circulatory death occurs when someone has a nonsurvivable brain injury but because all brain function hasn't ceased, the family decides to withdraw life support and the heart stops. That means organs can spend a while without oxygen before being recovered, a time lag usually doable for kidneys and other organs but that can raise questions about the quality of hearts.
To counter damage and determine whether DCD organs are usable, surgeons can pump blood and oxygen to the deceased donor's abdominal and chest organs — after clamping off access to the brain. But it's ethically controversial to artificially restore circulation even temporarily and some hospitals prohibit that technique, called normothermic regional perfusion, or NRP.
Another option is to "reanimate" DCD organs in a machine that pumps blood and nutrients on the way to the transplant hospital. The machines are expensive and complex, and Duke's Dr. Joseph Turek said the devices can't be used for young children's small hearts — the age group with the most dire need.
New ways of preserving hearts
Turek's team found a middle ground: Remove the heart and attach some tubes of oxygen and blood to briefly assess its ability to function — not in a machine but on a sterile table in the operating room.
They practiced with piglets. Then came the real test. At another hospital, life support was about to be withdrawn from a 1-month-old whose family wanted to donate — and who would be a good match for a 3-month-old Duke patient in desperate need of a new heart. The other hospital didn't allow the controversial NRP recovery technique but let Turek's team test the experimental alternative.
It took just five minutes to tell "the coronary arteries are filling well, it's pink, it's beating," Turek said. The team promptly put the little heart on ice and raced it back to Duke.
Vanderbilt's system is even simpler: Infuse the heart with a nutrient-rich, cold preservative solution before removing it from the donor's body, similar to how hearts from brain-dead donors are handled.
That "replenishes the nutrients that are depleted during the dying process and helps protect it for transport," Williams explained, adding that Vanderbilt has performed about 25 such transplants so far. "Our view is you don't necessarily need to reanimate the heart."
More donated hearts are needed
There's a huge need for more transplantable hearts. Hundreds of thousands of adults suffer from advanced heart failure, yet many are never even offered a transplant because of the organ shortage.
Every year about 700 children in the U.S. are added to the transplant list for a new heart and about 20% die waiting. Turek said infants are at particular risk.
Last year, people whose lives ended via circulatory death made up 43% of the nation's deceased donors — but just 793 of the 4,572 heart transplants.
That's why many specialists say finding ways to use more of those hearts is crucial. The new studies are small and early-stage but promising, said Brendan Parent of NYU Langone Health, who directs transplant ethics and policy research.
"Innovation to find ways to recover organs successfully after circulatory death are essential for reducing the organ shortage," he said.
If alternatives pan out, "I absolutely think that cardiac programs will be thrilled, especially at hospitals that have rejected NRP."
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Nahar Net
3 days ago
- Nahar Net
Researchers try new ways of preserving more hearts for transplants
by Naharnet Newsdesk 17 July 2025, 14:12 Two university hospitals are pioneering new ways to expand lifesaving heart transplants for adults and babies — advances that could help recover would-be heart donations that too often go unused. The new research aims to overcome barriers for using organs from someone who dies when their heart stops. Called DCD, or donation after circulatory death, it involves a controversial recovery technique or the use of expensive machines. Surgeons at Duke and Vanderbilt universities reported Wednesday that they've separately devised simpler approaches to retrieve those hearts. In the New England Journal of Medicine, they described successfully transplanting hearts to a 3-month-old infant at Duke and three men at Vanderbilt. "These DCD hearts work just as well as hearts from brain-dead donors," said Vanderbilt lead author Dr. Aaron M. Williams. How hearts are saved for donation Most transplanted hearts come from donors who are brain dead. In those situations, the body is left on a ventilator that keeps the heart beating until the organs are removed. Circulatory death occurs when someone has a nonsurvivable brain injury but because all brain function hasn't ceased, the family decides to withdraw life support and the heart stops. That means organs can spend a while without oxygen before being recovered, a time lag usually doable for kidneys and other organs but that can raise questions about the quality of hearts. To counter damage and determine whether DCD organs are usable, surgeons can pump blood and oxygen to the deceased donor's abdominal and chest organs — after clamping off access to the brain. But it's ethically controversial to artificially restore circulation even temporarily and some hospitals prohibit that technique, called normothermic regional perfusion, or NRP. Another option is to "reanimate" DCD organs in a machine that pumps blood and nutrients on the way to the transplant hospital. The machines are expensive and complex, and Duke's Dr. Joseph Turek said the devices can't be used for young children's small hearts — the age group with the most dire need. New ways of preserving hearts Turek's team found a middle ground: Remove the heart and attach some tubes of oxygen and blood to briefly assess its ability to function — not in a machine but on a sterile table in the operating room. They practiced with piglets. Then came the real test. At another hospital, life support was about to be withdrawn from a 1-month-old whose family wanted to donate — and who would be a good match for a 3-month-old Duke patient in desperate need of a new heart. The other hospital didn't allow the controversial NRP recovery technique but let Turek's team test the experimental alternative. It took just five minutes to tell "the coronary arteries are filling well, it's pink, it's beating," Turek said. The team promptly put the little heart on ice and raced it back to Duke. Vanderbilt's system is even simpler: Infuse the heart with a nutrient-rich, cold preservative solution before removing it from the donor's body, similar to how hearts from brain-dead donors are handled. That "replenishes the nutrients that are depleted during the dying process and helps protect it for transport," Williams explained, adding that Vanderbilt has performed about 25 such transplants so far. "Our view is you don't necessarily need to reanimate the heart." More donated hearts are needed There's a huge need for more transplantable hearts. Hundreds of thousands of adults suffer from advanced heart failure, yet many are never even offered a transplant because of the organ shortage. Every year about 700 children in the U.S. are added to the transplant list for a new heart and about 20% die waiting. Turek said infants are at particular risk. Last year, people whose lives ended via circulatory death made up 43% of the nation's deceased donors — but just 793 of the 4,572 heart transplants. That's why many specialists say finding ways to use more of those hearts is crucial. The new studies are small and early-stage but promising, said Brendan Parent of NYU Langone Health, who directs transplant ethics and policy research. "Innovation to find ways to recover organs successfully after circulatory death are essential for reducing the organ shortage," he said. If alternatives pan out, "I absolutely think that cardiac programs will be thrilled, especially at hospitals that have rejected NRP."
Nahar Net
4 days ago
- Nahar Net
2026 World Cup's contingency plans for wildfire smoke risks remain unclear
by Naharnet Newsdesk 16 July 2025, 17:40 The 2026 World Cup being hosted by Canada, Mexico and the United States is less than a year away and FIFA's protocols for matches affected by wildfire smoke remain unclear. The 48-team World Cup will run from June 11 to July 19, 2026. Canada is hosting 13 matches — seven in Vancouver and six in Toronto. The day after Toronto's air quality was among the worst in the world, the organizing committee for the World Cup in Canada declined to reveal guidelines for postponement or air quality related contingencies with soccer's international governing body. No policies are posted publicly. The Air Quality Health Index rating for Toronto was over 10, or "very high risk," on Monday morning, dropping to a "high risk" rating of 8 by late afternoon. This year's fire season, according to Canadian government data, is the second-largest on record. Canada's most destructive wildfire season was in 2023, with more than 6,000 fires burning 37 million acres (15 million hectares) of land, according to Natural Resources Canada. Dr. Howard Shapiro, Toronto's associate medical officer of health, said in a statement that Toronto Public Health is actively reviewing the latest evidence and best practices for air-quality issues as the city prepares for the World Cup. "TPH may provide guidance and recommendations on public health risks, including environmental health concerns such as extreme weather and wildfire smoke," the statement read. "This includes contingency planning to support the health and safety of residents, visitors, and participants during the tournament." Outdoor activities on days when the Air Quality Health Index rises higher than 7 should be rescheduled, said Dr. Andrew Halayko, a professor of physiology and pathophysiology at the University of Manitoba, to protect the most vulnerable, including people who are 65 or older, pregnant, young children and those with existing health conditions. But others say it's difficult to pinpoint exactly when the air quality reaches a threshold where sporting events should be canceled. "I personally think that we can't, based on good evidence, have general statements about what AQHI is unacceptable for a given event. Everything is contextual," said Dr. Christopher Carlsten, the head of the respiratory medicine division at the University of British Columbia. That context includes the age of the general audience and the forecast of the air quality, and events should be judged on a case-by-case basis, he said. The impact of poor air quality on athletes is a subject of debate. Some experts think athletes can better handle poor air conditions because they are generally young and healthy, making them less likely to sustain long-term health impacts. Michael Brauer, a professor at the University of British Columbia's Faculty of Medicine, said that studies show that even low levels of pollution impact cognitive ability — which not only affects performance but also increases the risk of injuries. "Imagine two players going up for a pass at really high speeds, and if you make one tiny error, that could be a career-threatening injury," he said. The Canadian Football League doesn't play games when the AQHI surpasses a threshold of seven, according to an agreement with the players. Those games are postponed.
Nahar Net
4 days ago
- Nahar Net
20 Palestinians killed at Gaza aid distribution site
by Naharnet Newsdesk 16 July 2025, 14:15 Twenty Palestinians were killed Wednesday in the crush of a crowd at a food distribution site run by an Israeli-backed American organization in the Gaza Strip, the group said, the first time it has acknowledged deadly violence at its operations. The deaths came as Israeli strikes killed 41 others, including 11 children, according to hospital officials. The Gaza Humanitarian Fund accused the Hamas militant group of fomenting panic and spreading misinformation that led to the violence, though it provided no evidence to support the claim. It said 19 people were trampled in a stampede and one person was fatally stabbed at a hub in the southern Gaza city of Khan Younis. Gaza's Health Ministry and witnesses said GHF workers used tear gas against the crowd, inciting a panic. The ministry said that it was the first time people have been killed by a stampede at the aid sites. It was also the first time that GHF has confirmed deaths at one of its distribution sites, although Palestinian witnesses, health officials and U.N. agencies say hundreds of people have been killed while heading to the hubs to get food. Stun grenades and pepper spray caused chaos, witnesses say Some witnesses said the crowd panicked after receiving messages that no aid would be distributed or would only be distributed later. Others said people became trapped while attempting to move through a turnstile system, which creates a bottleneck. Omar Al-Najjar, a resident of the nearby city of Rafah, said people were gasping for air, possibly from tear gas. The injuries were "not from gunfire, but from people clustering and pushing against each other," Al-Najjar said as he carried, with three other men, an injured stranger to a hospital. He said the chaos at the sites is forcing Palestinians to "march towards death." "They used stun grenades and pepper spray against us," said Abdullah Aleyat, who was at the GHF site on Wednesday morning. "When they saw people killing each other, they opened the gate and people stepped over each other and suffocated," Aleyat said, as he stood in a hospital room with some of the injured. Videos released earlier this year by GHF from an aid distribution showed hundreds of Palestinians jostling for aid, and sprinting towards the sites when they opened. In other videos obtained recently by The Associated Press from an American contractor working with GHF, Palestinians seeking access to the sites are pictured crowded between metal fences, as contractors deploy tear gas and stun grenades. The sites are inside Israeli military zones protected by private American contractors. Israel troops surround the sites, but the army says they are not in the immediate vicinity. The United Nations human rights office and Gaza's Health Ministry said Tuesday that 875 Palestinians in the enclave have been killed while seeking food since May, with 674 of those in the vicinity of aid distribution sites run by GHF. The ministry and witnesses say most of the deaths have come from Israeli gunfire. The Israeli army says it fires warning shots and only uses live fire if crowds threaten its soldiers. GHF, an American organization registered in Delaware, was established in February to distribute aid during the ongoing Gaza humanitarian crisis. Across Gaza, strikes kill 41 as Israel opens a new military corridor Meanwhile, Israeli strikes killed 22 people in Gaza City, including 11 children and three women, and 19 others in Khan Younis. The Israeli military said it has struck more than 120 targets in the past 24 hours across the Gaza Strip, including Hamas military infrastructure of tunnels and weapons storage facilities. Israel blames Hamas for the civilian deaths because the group often operates in residential areas. Also on Wednesday, the Israeli military announced the opening of a new corridor — the fourth — that bisects Khan Younis, where Israeli troops have seized land in what they said is a pressure tactic against Hamas. In the past, these narrow strips of land have been a serious hurdle during ceasefire negotiations, as Israel has said it wants to maintain military presence in them. Negotiations in the Qatari capital between Israel and Hamas are at a standstill, after 21 months of war, which began with the militants' cross-border attack on Oct. 7, 2023. That day, militants killed some 1,200 people, mostly civilians, and abducting 251 people, most of whom have since been released in ceasefire agreements or other deals. Fifty hostages are still being held, less than half of them believed to be alive. Israel's retaliatory offensive has killed over 58,000 Palestinians, according to Gaza's Health Ministry, which has said women and children make up more than half of the dead. It does not distinguish between civilians and militants in its tally. The ministry is part of the Hamas-run government. The United Nations and other international organizations consider its figures to be the most reliable count of war casualties.
