Dead heart restarted: Transplant that gives life to 3-month-old baby

Surgeons at Duke University in the US successfully transplanted a donor heart into a 3-month-old baby after it stopped beating for more than five minutes and restarted it on the operating table.

Experts used a specially designed system in the operation, which was performed with the donor family's consent. The heart was revived outside the body using devices such as an oxygenator , centrifugal pump, and blood collection reservoir.

The baby remained healthy for six months

According to the scientific report, six months after the transplant, there was no heart rejection or dysfunction in the baby. Experts attribute this success to the "tabletop resuscitation" method developed for small organs like the baby's heart.

Current devices are too large to protect adult organs, making them ineffective for babies' hearts. This new system is the first solution suitable for babies' organs.

Ethical debates are on the agenda

In most transplants, donors are brain dead. However, donations after cardiac arrest and blood circulation is cut off—"circulatory death"—are less common. Only 0.5 percent of pediatric heart transplants in the US are performed this way.

Some critics argue that restarting heart-stopped patients with a heart machine can obscure the definition of death and raise ethical issues. But the Duke team argues that restarting the heart outside the body mitigates these issues.

New approach from Vanderbilt

Vanderbilt University surgeons, trying a different approach to minimize ethical risks, opted for heart protection without restarting it. The heart's circulation was clamped at the aorta, preventing blood flow to the brain and diverting oxygenated preservative fluid to the heart.

Three baby hearts have been successfully transplanted using this method, and the initial results have been positive.

Both approaches, published in the New England Journal of Medicine (NEJM), suggest that these advances could improve the chances of success in pediatric organ transplants and reduce the number of babies who die on waiting lists.