Doctors excited as heart pumps obviate need for transplants
11 April 2017
British doctors on Monday hailed a medical procedure which sees patients with severe heart disease recover full fitness – without the need for an expensive and difficult transplant.
Nearly two-fifths of sufferers went on to make a full recovery when they were given the mechanical pump.
A national (and indeed global) shortage of donated hearts for transplant is leading to calls for the battery-operated machines to be considered as a tool which can allow patients to enjoy fully restored health.
The pumps are currently used to support patients with severe heart failure while they wait for a transplant.
Nearly two-fifths of sufferers made a full recovery when they were given the mechanical pump
A spokesman for the team at Newcastle University, Dr Djordje Jakovljevic, said, ''For the first time, what we have shown is that heart function is restored in some patients to the extent that they are just like someone healthy who has never had heart disease.''
He added, ''We talk about these devices as a bridge-to-transplant, something which can keep a patient alive until a heart is available for transplantation.'' But the ground-breaking research showed how some patients were able to recover to such an extent that they no longer need the transplant.
''In effect, these devices can be a bridge to full recovery in some patients,'' said Dr Jakovljevic.
The researchers examined the effect of mechanical heart pumps, known as left ventricular assist devices (LVADs).
Surgeons implant the machine, which helps the main pumping chamber of the heart – the left ventricle – to push blood around the body.
Fitted at the six specialist National Health Service centres across Britain, LVADs are used for patients who have reached the end stage of heart failure.
Publishing in the Journal of American College Of Cardiology, the team explained the clinical trial, where 58 men with heart failure were tested for their heart fitness levels. Of those, 16 were fitted with an LVAD and then had it removed due to their recovery. Eighteen still had an LVAD and 24 patients were waiting for a heart transplant.
On average, a patient had a device fitted for 396 days before it was removed. The participants were compared with 97 healthy men who had no known heart disease.
The authors said 38 per cent of people who recovered enough to allow the device to be removed demonstrated a heart function equivalent to that of a healthy individual of the same age.
Dr Jakovljevic said, ''We can consider these pumps as a tool which can lead to a patient recovering, rather than as a device which keeps people alive until a heart transplant is available.''
Now the team is researching markers that will indicate if and when to remove the pumps while ensuring heart failure will not occur again.
The average price of a LVAD is around £80,000 and the transplant operation costs £69,000.
Dr Guy MacGowan, consultant cardiologist within the Newcastle upon Tyne Hospitals NHS Foundation Trust, and Honorary Clinical Reader in Heart Failure at Newcastle University, is co-author of the paper.
He said, ''It is very difficult to get a heart transplant, especially in the UK, so any alternative treatment is important and recovery of heart function especially so.''
Cardiovascular (heart and circulatory) disease causes 26 per cent of all deaths in the UK, with nearly 160,000 deaths each year.
Professor Jeremy Pearson, associate medical director at the British Heart Foundation, said, ''This research is extremely encouraging and shows there may, finally, be hope for people who are living with advanced heart failure.
"But it's vital we continue funding research into repairing damaged hearts.''