Researchers developed a new device called ‘Heart in a box’ which keeps the heart alive for transplant even after it has stopped beating in its original body. This is a great news for people waiting for heart transplant. However, it’s raising a big ethical question on how one can declare the person as “dead” and if we can restart their heart in someone else’s (recipient) body.
Currently, a person awaiting heart transplant can have the heart of a vegetative or a brain dead patient, with prior consent from the patient’s family members, because transplanting a heart from a deceased person is considered too risky.
Hearts from vegetative patients can be cooled down inside the body when the person is still alive, gently stopped, extracted, and transported in a container at around 4°C. Cooling reduces the metabolic activity which gives doctors enough time to transplant and get it into beating again before it runs out of oxygen. And by the time the heart comes back to its normal temperature and starts beating it is safe in a new body and can acquire its required supply of oxygen.
All the heart transplants and also other organ transplants around the world are done this way, but there is more demand and many are in need of heart transplants now.
In the past, organs were traditionally cooled to preserve them for transplantation. A new device called “Heart in a box” will help the heart from people who have died recently to bring them back to life and then transplant them in other people thus saving their lives.
In other words, it means the device is able to bring a ‘dead heart’ back to life even after it has stopped beating in its original body.
Developed by Massachusetts-based company, Transmedics, the new heart-in-a-box device works by keeping the extracted heart warm, not cool. The heart is transferred to a sterile chamber fitted on a wheeled cart, inside which tubing is clamped onto the organ to give it a constant supply of oxygen, blood, and nutrients. The team behind the design says this will likely prolong the amount of time a heart can be kept functional outside a body.
“A human organ has never been kept alive outside of a human body until this machine became a clinical reality,” said Abbas Ardehali, the head of University of California, Los Angeles’s heart and lung transplant program. “It makes intuitive sense to a layperson to say, ‘Instead of having my heart on ice, I want it to be warm. I want it to be beating.'”
The major downside of this new method is being too expensive with the price tag of US$250,000 a piece. More questions also arise about possibility of reviving the dead heart by this device and giving back to the original owner.
It’s certainly an interesting question but Robert Truog, Harvard ethicist clearly says that a person who is declared dead is dead.
He further told that “My argument is that they are not dead, but also that it doesn’t matter. They are dying and it’s permissible to use their organs. The question is whether they are being harmed, and I would say they are not.”
However, Truog also added that this is entirely the call of the family, if they want to give the heart of their family member to someone in need.
With technology growing and getting more sophisticated for reviving and preserving organs and considering that many people are in need of heart transplantation, this device is definitely helpful. It could increase the amount of donated hearts by up to 30 percent.
More on this can be read here.