Donor heart travels 12 hours across Atlantic before use in successful transplant in world first
Lauren Chadwick
Surgeons in Paris successfully carried out a heart transplant earlier this year after a donor organ travelled across the Atlantic Ocean for the rst time.
The heart came from a 48year-old man in the French West Indies who was declared brain dead three days after a stroke.
It was then transported to Paris in the cabin of a commercial Air France ight and was preserved for twelve hours.
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The recipient was a 70-yearold man who was discharged from the hospital 30 days after surgery.
Dr Guillaume Lebreton, a heart surgeon at La PitiéSalpêtrière Hospital in Paris, travelled with the organ and performed the successful heart transplant.
It’s part of a pilot study where donor hearts from Guadeloupe and Martinique are preserved “in a perfusion machine, a sort of special cooler with a pump inside that injects blood and oxygen into the heart,” Lebreton told Euronews Health.
“This pilot study aims to show that it is possible to increase preservation times beyond the usual four hours, up to 12 or even 14 hours,” he added.
The surgeon said it was the rst time a donated heart was own across the Atlantic Ocean, covering a distance of 6,750 km to Paris.
This is “a feat previously unimaginable in organ transplantation,” Lebreton and his colleague Pascal Leprince wrote in an article published in The
Lancet.
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The pilot study will continue until they have carried out seven heart transplants that were conserved this way, which the doctors aim to do in 36 months.
They used a Swedish XVIVO Heart Assist Transport device, which is still awaiting o cial regulator approval.
If the study continues to be successful, the doctors can propose these transplants to the standard list of recipients.
That will change a lot of things in heart transplantation because currently, we have to race against the clock. Guillaume Lebreton Heart surgeon
"That will change a lot of things in heart transplantation because currently, we have to race against the clock," said Lebreton.
"If we remove this time constraint, we will at the same time remove geographical constraints," he said, adding that it could improve the conditions under which they perform these surgeries.
The hope is also to increase access to transplants as there is a shortage of donor organs available. For every donor heart in France, there are typically two people on a waiting list, Lebreton said.
Around 7,000 people in Europe died in 2022 while waiting for an organ transplant, according to the European Directorate for the Quality of Medicines and Healthcare.
Luciano Potena, former president of the European Society for Organ Transplantation, said that the approach of the Paris team "will improve the e ectiveness organ procurement in remote areas, the adequacy organ allocation and the logistics of the entire process" as well as organ availability.
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"The device is still under investigation and is not yet available for clinical use, but preliminary data looks very promising and, if con rmed, will prompt a revolutionary improvement in the entire heart transplant process, allowing larger access to care and increasing access to this life-saving intervention," Potena added.
Alvaro Rojas-Peña, an assistant research scientist in transplant surgery at the University of Michigan in the US, said that there have been a couple of heart transplants with organs preserved for more than 10 hours.
But in those cases, doctors used a di erent machine and the hearts took time to work properly.
'Very relieved'
Rojas-Peña recently carried out a study demonstrating even longer preservation times for animal hearts, with one paper under review that demonstrated 28 to 32hour preservation for a pig heart.
As for how he felt after completing the surgery, Lebreton said he was "very relieved".
"I expected it to work, of course, because animal studies have shown that we can preserve [donor organs] for longer. We were [also] working on this study for months to obtain [o cial] authorisations so the research had to be convincing to do so," he said, pointing out that multiple French public agencies made the work possible.
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"But when you are going to remove the heart and are on the plane with the heart, and have to carry out the transplant, there is a little moment of anxiety… but we were relieved quite quickly,” he said, as the heart started beating and functioning normally.
Three months on, the man who received the heart transplant is "doing well. He is at home and leading a normal life".
Editor's note: This story has been updated to include comments from an independent expert.