Minneapolis Heart Institute Foundation completed the first two successful heart transplants in the state and is one of only seven clinical sites in the country participating in a new research study to evaluate a new technology that has the potential to change the way we do heart transplants and give hope to the 3,400+ patients in the U.S. who remain on a waitlist for a heart every year.
Traditional heart donations come from a donor who is declared brain dead but remains on life support. This is called donation after brain death, or DBD. An alternative and growing number of donations are performed in patients who have had catastrophic brain injuries though are not brain-dead. These patients are allowed to pass after their heart stops beating. Organ procurement for kidneys, lungs and liver have been successfully utilized from these donors. This is called donation after circulatory death, or DCD. Unfortunately, a heart cannot be procured with traditional methods from these donors.
New research using an investigational technology reanimates and resuscitates a DCD donor heart that has stopped beating. The support system allows the heart to recover and continually beat in its self-contained module. The heart is continually monitored using several parameters for adequate recovery to be used in a subsequent heart transplant. This research is currently underway at the Minneapolis Heart Institute Foundation, where the transplant team has a vision of challenging the limitations experienced today with such few hearts that become available through traditional procurement. The process involves a collaborative team of cardiothoracic surgeons, cardiologists, transplant coordinators, specialty care perfusionists, research coordinators, pharmacists and an organ procurement organization.
Kevin Manion: A New Heart Transplant and Second Chance
Kevin grew up living a normal, healthy childhood not knowing his life would take him on quite a journey with his heart health. It was not until he was an adult – and really after three heart attacks – that it was a fourth heart attack that put him in a challenging position with his heart. That’s when he came to Abbott Northwestern Hospital, met Dr. Kasia Hryniewicz and learned how damaged his heart had become.
Kevin’s fourth heart attack, was the most serious kind of a heart attack (called a STEMI), and it left his heart damaged and unable to effectively pump blood throughout his body. That was when he was told he need to go on a left ventricular assist device (LVAD), a mechanical pump that is implanted inside the chest to help a weakened heart pump blood.
“I knew that they had referred to it as a bridge to transplant, but nobody seemed to say that around me,” said Kevin. “I certainly thought that I’d be wearing the LVAD for five years or maybe hopefully a little bit more, trying to get as many years as possible.”
One year after receiving his LVAD, Kevin developed an infection and as a result, his only option was to get a heart transplant. Kevin received a call from Kari Thomas, a research coordinator at the Minneapolis Heart Institute Foundation, to let him know about a research study for patients like him in need of a heart transplant.
“There was just never a question in my mind and it wasn’t about self-gain,” said Kevin. “Why wouldn’t I participate in research? I want to do something to help. I’m 57 now, so I’m at a stage in life where I’m looking to contribute in any way I can. I agreed wholeheartedly to participate.
Nobody ever mentioned a timeline for the research study or how quickly a heart would become available for Kevin, but within a week he received the call that they’d found a heart.
“I could almost hear the tears when Erin called me and she said, ‘We’ve located a heart, but don’t get too overjoyed at this point yet. We still got a lot of steps to go through, and the heart is still with its donor, and we’ve got a lot of work to do. I need you to try and get some sleep and we’ll talk in the morning.’ Sure enough, we did,” said Kevin.
Kevin learned the next morning that it was all a go. The transplant team at the Minneapolis Heart Institute Foundation, including cardiothoracic surgeons Karol Mudy, Bassam Shukrallah, and Benjamin Sun were ready to work through Kevin’s case. He was enrolled as the second patient to receive a heart through the DCD research study utilizing the heart-in-a-box technology.
“The team of physicians who worked on my case are incredible,” said Kevin. “When I woke up Dr. Sun was in the room. I had to ask him, ‘Did we do the whole operation?’ I was in a time warp and they told me all along the way that there was a possibility it doesn’t happen, that I’d wake up and still be wearing the LVAD. But Dr. Sun said, ‘Yep, we did the whole thing.’”
Kevin is grateful for his new heart. And looking forward to big plans ahead, including rollerblading with the cardiologist, Dr. Hryniewicz, who helped him on this journey to the LVAD and to the research study that found him a new heart and a new lease on life. He also fondly recalls the sign he saw on the wall in the hospital when he first learned about the challenges with his heart. The sign said, “The heart is happiest when it beats for others.”
“It was right then that I said, “Okay, this is not about me anymore. This is about Shelby and Eamonn, my wife and son,” said Kevin. “It’s about so many other people that care for me. That little saying means a lot to me.”
About Heart Transplants in the U.S.
According to UNOS, about 3,658 U.S. heart transplants were performed in 2020. This number has grown slightly, with capacity to perform the procedures but with extreme limitations due to a lack of donors. Nearly the same number of patients (more than 3,400) remain on the waiting list each year. This new technology holds promise to address an unmet need, and potentially years of additional life, for so many more patients.
About the “Heart-in-a-Box” Technology
The technology is the Organ Care System (OCS™) manufactured by TransMedics. It is often called the “heart-in-a-box” and is a portable, warm perfusion, and monitoring system designed to keep a donor heart at a human-like, metabolically active state. By monitoring key parameters of the functioning heart, physicians may use their medical judgement to assess a potentially suitable heart’s condition and viability.