Medical experts defy odds to adjust adult 'heart box' treatment for children

Written on 02/22/2021
Ciarán Mather

UK doctors have reportedly become the first in the world to complete heart transplants in children through a process previously deemed incompatible with children.

The process involves the use of a 'heart in a box': it is engineered to emulate the human body, keeping the heart warm, beating and pumping blood so it is healthy for transport to the recipient. 

While its informal moniker makes it sound like a collaboration between the grunge rock bands Alice in Chains and Nirvana, its official name is the Organ Care System (OCS).

The idea behind the machine was to allow for the organ to be transported across long distances.

The discovery and research into the procedure came from a team of surgeons at the Royal Papworth Hospital (RPH) in Cambridgeshire and cardiothoracic surgeons at Great Ormond Street Hospital, while the OCS is the product of the American company TransMedics.

According to The Guardian, Great Ormond Street has 24 children waiting for a heart transplant, and between 2014 and 2019 the average waiting time was 282 days.

Marius Berman, a consultant cardiothoracic transplant surgeon at the RPH in Cambridge, explained the main advantage of the procedure: 'Transplant waiting times are significantly lower at RPH than the national average, [but] not because we’re better surgeons; it was because the new approach saved time and money.'

The first child to receive a transplant based on the new approach was 15-year-old Anna Hadley, who was diagnosed with restrictive cardiomyopathy in 2018.

The procedure is now a collaboration between RPH, whose team retrieves the heart, and Great Ormond Street hospital in London, whose team implants the organ.

It has since been noted that the per-use cost of the existing OCS machine is about £50,000 (around €57,807.34), but in effect, it actually costs less than having heart patients waiting for organs. 

The OCS is limited to donors who weigh at least 50kg, but the two hospitals are working on a new machine that will enable donation from bodies, even those of infants, which could usher in an era of transplantation for babies and young children where donors are the scarcest.

A prototype has since been announced and the team of doctors have said that they expect to start using the machine by the end of this year.

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