Duke Health pioneering new technique to save more infants in need of heart transplants

DURHAM, N.C. (WTVD) -- Duke Health has discovered a groundbreaking approach that may offer new hope to families on a heart transplant waitlist by 20%.

Duke Scientists are calling the new technique "on-table heart reanimation," to ensure pediatric donor hearts are used.

The duke team created a new method that temporarily reanimates the donor heart outside of the body on a surgical table using a heart-lung machine (extracorporeal membrane oxygenation or ECMO).

The innovative approach avoids logistical and ethical barriers and could become the new standard of care.

"This innovation was born out of necessity. We were determined to find a way to help the smallest and sickest children who previously had no access to DCD (donor after cardiac death) heart donation," said Joseph Turek, M.D., Ph.D., senior author of the study and chief of pediatric cardiac surgery at Duke Health.

"This is a major step forward in pediatric transplant medicine. On-table heart reanimation could dramatically expand the availability of precious donations-transforming loss into life with greater stewardship and hope."

Turek's team found a middle ground: Remove the heart and attach some tubes of oxygen and blood to briefly assess its ability to function - not in a machine but on a sterile table in the operating room.

They practiced with piglets. Then came the real test. At another hospital, life support was about to be withdrawn from a 1-month-old whose family wanted to donate - and who would be a good match for a 3-month-old Duke patient in desperate need of a new heart. The other hospital didn't allow the controversial NRP recovery technique but let Turek's team test the experimental alternative.

It took just five minutes to tell "the coronary arteries are filling well, it's pink, it's beating," Turek said. The team promptly put the little heart on ice and raced it back to Duke.

According to the United Network for Organ Sharing, every year in the U.S., 700 children are added to the waitlist for a pediatric heart transplant, and 10-20% die while on the waitlist.

Last year, people whose lives ended via circulatory death made up 43% of the nation's deceased donors - but just 793 of the 4,572 heart transplants.

Duke Health has a history of pioneering research in DCD heart transplants, performing the nation's first DCD heart transplant in an adult in 2019 and the first in an adolescent in 2021.

The Associated Press contributed to this report.