21.08.2019

Newcastle surgeons perform their first ever heart transplant following circulatory death

Surgeons at Newcastle Hospitals have successfully performed their first ever heart transplant from a donor who died when their circulation stopped.

The five-hour procedure, which was carried out by specialists in the Institute of Transplantation at the Freeman Hospital, marks a new form of transplantation which could increase the number of heart transplants by a fifth.

 

For the first time, the team used a heart from a donor who donated after circulatory death (DCD) – where their heart stopped beating. This is a technique which is already used in other areas of transplantation, including kidneys and livers, and for which the UK is recognised as a world leader through its DCD programme.

It involved restoring function to the heart to allow safe assessment of the organ before it was accepted for transplantation. The heart was then placed onto an organ care system (OCS) – pioneering ‘heart in a box’ technology - to maintain its quality during transportation to Newcastle to be transplanted into 65-year-old Kenneth Morris.

Ex-military Kenneth Morris from Carlisle collapsed suddenly during an orienteering event and at aged 42 was diagnosed with dilated-cardiomyopathy, disease of the heart muscle.

Following diagnosis, Kenneth’s condition was managed with medication and he was fitted with several ICDs (implantable cardioverter-defibrillators), until he became unwell and was placed on the urgent transplant list.

“There was a turning point for me one day, I knew that when I couldn’t cross the street without getting out of breath, that my heart was failing.” Kenneth said.  

After two years of waiting for a suitable donor, Kenneth was offered the opportunity to join the Donation after Circulator Death programme – making him Newcastle Hospitals’ first to patient receive a heart transplant through this type of donation.  

Kenneth was waiting at the airport in Manchester to fly out to Rome to meet his partner Elaine, when he received the lifesaving call.

He said: “I was in the mindset that I was either waiting to die or I would wait for a new heart – so I decided to start doing all the things I wanted to do and enjoy living my life. I was in the departure lounge of the airport when the transplant co-ordinator called me to say they had a heart for me.

“I’ve been meant to meet Elaine in Rome three times now and still haven’t made it! I’ve missed flights and all sorts, so when I rang her to say I wasn’t coming, she replied: ‘what now?’”

“I feel extremely blessed to be the first person to have this treatment - it’s a privilege. I was in the right place at the right time – another few hours and I would have been on a plane on my way to Rome.”

Since having his heart transplant, Kenneth decided to sell his car and start walking more in honour of the gift of life he received.

“I recently walked 11 miles along Hadrian’s Wall and plan to do as much walking, keeping fit and looking after this heart as long as I can – and as often as I can - in honour of the family and the person who has lost their life.

“Of all my years in the army, I don’t think I’ve ever come across the courage this family and the donor have shown.”

Asif Shah, Consultant Cardiothoracic Surgeon at Newcastle’s Freeman Hospital who performed the operation, said: “We are delighted with Kenneth’s progress following his heart transplant using this new technique.

“Kenneth presented with end-stage heart failure due to cardiac arrhythmia cardiomyopathy and was placed on the urgent transplant list. His transplant was a great success and he recovered remarkably well and was discharged home five weeks later.

“Previously we couldn’t use these hearts for transplantations because the heart has stopped beating, but this procedure sees the organ restart using a beating machine, which restores the energy supply during the journey from the donor hospital to the recipient hospital.

“We are hopeful that this procedure will, in the future, enable around 20% more hearts to be available to the many patients currently on our transplant waiting list.”

Professor Derek Manas, Director of the Institute of Transplantation said: “We have been developing this technique for transplanting kidneys, lungs and livers from DCD donors for a number of years now.

“Until recently heart transplantation was only possible from donors after brain-stem death (DBD), so to use DCD donors successfully for the first time at Newcastle Hospitals is an extremely exciting and important development for North East patients.

“It is important to note that this achievement would not have been possible without the ‘ground breaking’ work carried out at Papworth and Harefield as well as the very generous financial support of the Children’s Heart Unit Fund that has been instrumental in bringing this technology to Newcastle.

“We are also immensely grateful to the donor’s family and we hope they are taking great comfort in knowing that their relative’s organs have saved lives and made such an important contribution to developing heart transplantation in the UK.”

Across the UK, there are currently around 6,000 people on the UK transplant waiting list and last year, over 400 people died while waiting for a transplant.

Professor John Forsythe, Medical director for organ donation and transplantation at NHS Blood and Transplant, said: "British surgeons and researchers lead the way in this new form of heart transplant and we welcome this wonderful news for the Newcastle unit.

“NHS Blood and Transplant is working closely with a number of transplant centres in the UK to carry out transplants from donors who have gifted their heart after death has been confirmed after their circulation has stopped. There were fewer heart transplants carried out last year compared with the year before, so using new techniques like this can help more people to get the hearts they so desperately need.

“Whilst Newcastle’s news is very encouraging, it must not distract us from the overwhelming need for more organs. There are currently more than 6,000 patients waiting for an organ transplant across the UK, 315 of whom are waiting for a heart transplant. Sadly, in the UK someone dies every day in need of a transplant.

“With organ donation law changing in England and Scotland in 2020 it’s important for people to have the conversation and make their decision known to those closest to them.”

Currently only 6 other centres carry out this type of operation but their results, which sees the non-beating heart restored with energy from a “beating machine” as it is transported from the donor to the recipient, are comparable, if not better, than transplants from brain-dead donors – with a 90-93 per cent survival to discharge rate.

From spring 2020, all adults in England will be considered to have agreed to be an organ donor when they die unless they had recorded a decision not to donate or are in one of the excluded groups. Make a decision whether you want to pass on your organs and save lives. You have a choice. There is lots of information to help you make your decision and you can record your decision to opt in or opt out at www.organdonation.nhs.uk or via 0300 303 2094

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