“Up to 50% more heart transplants could occur as a result of Heart in a Box,” says a charity spokesperson for the Queen Elizabeth Hospital Birmingham (QEHB), where the ground-breaking medical device has been a success for UK medicine.

What is it?

The ‘Heart in a Box’ created by US company TransMedics Inc. is a revolution in heart transplantation. Through a constant flow of oxygen and nutrient-rich blood, the donor heart keeps beating outside of the body in a small portable box. The box simulates the conditions of the human body, allowing the heart to function normally and make it more viable for transplant.

At a hefty price tag of £264,000 per machine, Heart Research UK is trying to raise money for Heart in a Box to be used more often.

Previously, transplants used only still-beating donor hearts from brain-dead patients. With the Heart in a Box, the hearts are donated after circulatory death (DCD), where the heart has stopped beating. Unlike the usual ice box method, this revolutionary machine means the heart does not deteriorate as quickly because of the flow of blood.

Reducing the risk of organ rejection

The QEHB Charity said that the portable nature of Heart in Box means they can recover hearts from a distance away. “With the ice box method this capacity is limited due to the four-hour window,” said their spokesman. This also means the hearts can be treated and tested, making sure it is in the best condition possible, and reducing the risk of organ rejection. “The heart can be suffused with immunosuppressant drugs, which stop the body rejecting the organ as a foreign object.”

James Walton, 34, is the first person at Queen Elizabeth Hospital Birmingham (QEHB) to have a heart transplant using the ‘Heart in a Box’ machine. “It has given me a whole new life,” he told the BBC.

The future of heart transplants

The world’s first series of successful transplants using the machine happened in Sydney in 2014 at St. Vincent’s Hospital Heart Transplant team. The two patients, each suffering congenital heart failure, recovered well after the operation. Telling the Telegraph, Professor MacDonald, one of the doctors involved in the process, said that with the help of this machine thousands more hearts could become available for transplantation.

James Walton’s is only the first in a long line of transplants made possible by this machine. According to the 2017-18 NHS Organ Donation and Transplantation Activity Report, as of 31st March 2018, there were 284 patients on the active heart transplant list. A total of 25 hearts donated after circulatory death (DCD) were transplanted. With TransMedics Heart in a Box, there could be many more.