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In what sense were previous heart transplants not dead? Would they only use hearts that were kept pumping right up until they were surgically removed from the d

by macksd 6y ago

In what sense were previous heart transplants not dead? Would they only use hearts that were kept pumping right up until they were surgically removed from the donor? I thought they were previously transported on ice, and assumed their must be some period of time during which the hard was considered dead - wondering what's so fundamentally different beyond the device that circulates donor blood through the heart.

carbocation 6y ago
I think this is an important question. Donation of organs after death can happen when people are declared dead due to brain death, or when they are declared dead due to classical criteria including cardiac death. "Donation after cardiac death", as you might imagine, seems a bit weird when the heart is the organ being donated. And so it's a recent invention for the heart (though it has been around for a long time for other organs such as the kidney[1]). There is a free access article from 2018 about the necessity and ethical considerations of cardiac donation after cardiac death in Circ: Heart Failure [2]. 1 = https://health.ucdavis.edu/transplant/nonlivingdonors/donation-after-cardiac-death.html https://health.ucdavis.edu/transplant/nonlivingdonors/donati... 2 = https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.118.004884 https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.118...
pontifier 6y ago
It seems like most other hearts were removed live after brain stem death. My take is that in this process, hearts that had stopped beating in a donor due to death from other causes were revived after removal.
frosted-flakes 6y ago
> Would they only use hearts that were kept pumping right up until they were surgically removed from the donor? Correct. I went through this with a family member who was struck by a car and later declared brain-dead in hospital—but his heart was still beating, and thus a candidate for heart donation. We said our final goodbyes before he was wheeled away for surgery, heart still beating and looking as alive as ever. The anonymous recipient underwent surgery simultaneously in the same hospital, so presumably the heart only stopped beating for a very short period of time before it was re-started, and it continues on beating to this day (it's a funny feeling, knowing that).

by macksd 6y ago

carbocation 6y ago

I think this is an important question. Donation of organs after death can happen when people are declared dead due to brain death, or when they are declared dead due to classical criteria including cardiac death. "Donation after cardiac death", as you might imagine, seems a bit weird when the heart is the organ being donated. And so it's a recent invention for the heart (though it has been around for a long time for other organs such as the kidney[1]). There is a free access article from 2018 about the necessity and ethical considerations of cardiac donation after cardiac death in Circ: Heart Failure [2]. 1 = https://health.ucdavis.edu/transplant/nonlivingdonors/donation-after-cardiac-death.html https://health.ucdavis.edu/transplant/nonlivingdonors/donati... 2 = https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.118.004884 https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.118...

pontifier 6y ago

It seems like most other hearts were removed live after brain stem death. My take is that in this process, hearts that had stopped beating in a donor due to death from other causes were revived after removal.

frosted-flakes 6y ago

> Would they only use hearts that were kept pumping right up until they were surgically removed from the donor? Correct. I went through this with a family member who was struck by a car and later declared brain-dead in hospital—but his heart was still beating, and thus a candidate for heart donation. We said our final goodbyes before he was wheeled away for surgery, heart still beating and looking as alive as ever. The anonymous recipient underwent surgery simultaneously in the same hospital, so presumably the heart only stopped beating for a very short period of time before it was re-started, and it continues on beating to this day (it's a funny feeling, knowing that).