Transplant surgeons are increasingly using artificial rather than donor hearts to such an extent that the use of donor hearts might become obsolete within the next decade, a renowned transplant surgeon has predicted.
Dr Willie Koen, a cardiac and transplant surgeon at the Netcare Christiaan Barnard Memorial Hospital in Cape Town, says mechanical heart implantation was changing the face of heart medicine and was likely to totally replace donor heart transplants within the next 10 to 15 years.
Speaking at the 26th World Congress of The World Society of Cardiothoracic Surgeons over the weekend, Koen said mechanical heart device implantation was already taking place twice as often as biological heart transplantation internationally and has changed the face of heart medicine.
“Mechanical implants do not as yet have the same longevity for the patient as the biological option but can nevertheless currently support a patient for between six to eight years.
“We fully expect this to improve, as artificial devices are undergoing rapid development, and there is little doubt that within the next decade or so they will have the longevity of the biological option, which is 20 years or more.
“The late Professor Christiaan Barnard, who performed the world’s first human-to-human heart transplant at Groote Schuur Hospital in Cape Town on December 3, 1967, commented in the Cape Times in 2000 after we implanted the first artificial Berlin Heart, that he did not believe that mechanical transplantation would ever replace biological heart transplantation.
“This is an indication of just how far artificial heart technology has come since then,” Koen said.
Koen explained that, unlike donor hearts, the mechanical devices were readily available and patients therefore did not have to be put on a waiting list, which tragically often resulted in patients running out of time and dying before a matching heart could be found. In addition, the artificial hearts, although relatively expensive, in most cases did away with the need to take costly anti-rejection drugs, which made it more cost-effective over the long term.
“We expect these technologies to become cheaper as they become more widely adopted. This will make them more accessible to patients around South Africa and indeed the rest of the African continent, where heart transplantation is not an option for the overwhelming majority of patients because it simply is not available to them,” Dr Koen said.
In May, 10-year-old Philasande Dladla from Johannesburg became the first child on the continent to receive a mechanical heart to enable his damaged heart to continue functioning. The young boy was on the transplant list, but another solution had to be found, as it was extremely difficult to find a suitable matching donor heart for him.
Dr Koen said the technology was currently reserved for critically ill patients who could not wait any longer for a matching biological heart and was ostensibly used as a temporary measure, but was in practice increasingly being used as an alternative.