WASHINGTON – Heart transplants are one of the true miracles of modern medicine, but there are not enough suitable donor hearts to even come close to meeting the rising demand.
Researchers at Stanford University found a growing number of donor hearts are being rejected, as the need for transplants rises.
“It is estimated that only one of ten individuals who would benefit from a heart transplant will actually receive one due to the lack of available hearts for transplantation,” says Dr. Warren Levy, chief medical officer at Virginia Heart, one of the largest cardiology practices in the region.
The Stanford study, published in the American Journal of Transplantation, shows donor heart utilization rates fell to 32 percent in 2010, down from 44 percent in 1995.
The researchers say the decline points to the need for a set of specific, scientifically-based guidelines to determine whether a donor heart should be used in transplantation. And they warn it is very likely that a significant number of suitable hearts are not being used.
Levy says the situation is complicated by a number of factors.
“In general, there are clear reasons not to accept a heart, such as prior heart damage, hepatitis B or C or HIV infection,” he says. But he adds, “when you have a really sick patient, it is up to the discretion of the surgeon as to how much risk they are willing to take to save a patient’s life.”
Another problem is that heart transplants are often a matter of location…location…location.
“The heart needs to be transplanted within four hours of being removed from the donor, and that limits the geography to about a 1,000-mile radius for donor hearts,” says Levy.
It stands to reason if medical science could come up with a way to extend the “life” of a donor heart, or build up one that is not quite perfect for transplantation, more transplants could be performed. But that is far easier said than done.
Silver Spring-based bio-tech firm United Therapeutics is conducting research to mend donor lungs. But so far, no one has made the leap to fixing donor hearts.
