Great Ormond Street and Royal Papworth introduce world-first paediatric heart transplant technique

Through a collaboration between Great Ormond Street Hospital (GOSH) and Royal Papworth Hospital (RPH) a new paediatric heart transplant technique has been introduced that has successfully expanded the donor pool and increased the number of transplants for eligible children in the UK by 50%. 

The donation after circulatory death (DCD) heart transplant programme was previously only available to adults, but now for the first time has been successfully made available to six children.

Using a portable organ perfusion system called the TransMedics heart Organ Care System (OCS), the technique means doctors are able to reanimate the heart, medicate it and keep it beating outside of a human body, keeping it healthy whilst it is transported to the recipient patient.

The clinicians involved in the programme said the technique helps to “widen the donor pool and allows for them to be transported further and gives surgeons and nurses time to assess an organ’s function and apply medication to the heart if required.” 

Speaking on the significance of the programme, Jacob Simmonds, Consultant Cardiologist and Transplant Physician at GOSH, said: “In early 2020 we had more children at GOSH on the transplant list than I’d ever seen in my 16 years working at the hospital. 

“Every day a child waits there is a bigger likelihood that they may get too ill even for transplantation, or worse. Although medical advances have come far, for some children with heart failure an organ donation is truly their only hope.

“With the DCD heart programme we have unlocked more opportunities for donation, essentially doubling the number of transplants done at GOSH in eligible patients weighing over 20kg. It’s game-changing and work is already underway to make the technique suitable for our much younger and smaller patients.

“Ultimately, though, this still relies on families having conversations around their organ donation wishes, and then of course the bravery to consider making this precious, life-saving gift at a time of unimaginable tragedy.”

The clinicians involved in the programme also commented: “The OCS machine is currently the only medical device capable of making DCD heart transplantation a clinical reality. Although this technology limits donation to donors who weigh at least 50kg – all six recipients under the programme so far are aged between 12 and 16 – the teams at RPH and GOSH are working together to develop a new machine that will enable DCD heart donation from even smaller infants, opening up a new dawn of transplantation for babies and young children, where donors are the most scarce.”