Grey Power June 2016

national Greypower mAGAZINE » june 2016 49
Sydney surgeons revolutionise cardiac
transplants with ‘heart in a box’
Surgeons from St Vincent’s Hospital in
Sydney have been refining a system
known colloquially as the ‘heart in
a box’ programme, to increase the
number of donor hearts potentially
available for transplantation.
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St Vincent’s is the
only unit in Australia
using the
TransMedics Organ
Care System, which
uses ex-vivo perfusion
to keep the heart
‘alive’. This involves
oxygenated warm
blood and medications
being pumped
through the donor
heart after removal
from the human body.
In some cases, hearts
have been flown interstate
between hospitals
in the sterile box, with
its blood pressure, pulse
and vital signs monitored
on a portable computer
screen.
Cardiothoracic surgeon
Dr Emily Granger
presented her research
recently at the Royal Australasian
College of Surgeons
Annual Scientific
Congress in Brisbane,
and said 18 patients
have now benefited from
hearts retrieved using
this technology.
“We have been researching
and refining
this system for more
than 15 years now, and
what is different about
it, is that it allows hearts
to be transplanted from
donors we previously
would have rejected,” Dr
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Granger says.
“We quickly transfer
the deceased patient to
the operating theatre,
place the stopped donor
Acute appendicitis possible indicator
of colorectal cancer in older adults
Older patients with appendicitis
may have
an increased risk of
colorectal cancer, delegates
to the Annual
Scientific Congress
(ASC) of the Royal Australasian
College of Surgeons
(RACS) were told
recently.
These findings arise
from research conducted
by Dr Rebecca Shine, a registrar
of general surgery,
alongside colleagues at the
Bay of Plenty DHB.
“With colorectal cancer,
if it can be detected
and treated early, then the
outcome for the patient
improves dramatically,” Dr
Shine said.
“Unfortunately, early
detection can prove difficult
as most patients only
present when the colorectal
cancer is at a more advanced
stage.”
New Zealand has among
the highest rates of colorectal
cancer in the Western
world with approximately
2800 new cases every year,
and between 1100 and
1200 deaths.
For patients
between 45
and 60 years
of age with
appendicitis,
there is a
seventeen fold
increase in this
risk.
According to the research
conducted by Dr
Shine and her colleagues,
the presence of acute appendicitis
may be an indicator,
which can help detect
colorectal cancer at an
earlier stage.
“The findings of our research
suggest that patients
45 years and over with appendicitis
are more than
six times as likely to have
a colorectal carcinoma as
those without.
“For patients between
45 and 60 years of age with
appendicitis, there is a seventeen
fold increase in this
risk.”
“Acute appendicitis may
therefore be an indicator
that a patient has colorectal
cancer, which potentially
could result in detection
earlier.”
“Our recommendation
is that all patients aged 45
years and above should be
considered for a full colonic
investigation following a
diagnosis of appendicitis,
regardless of histology or
preoperative imaging.”
The RACS Annual Scientific
Conference was held
Now we can
minimise
damage to
the heart by
keeping it
warm and
functioning
on the
Transmedics
OCS.
in May in Brisbane. The
conference brought together
the top surgical and medical
minds from across New
Zealand, Australia, and the
rest of the world.
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The active organisation for those 50+
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heart onto the organ care
system, connect up the
tubes and run the warm
blood.
“Our research shows
that if perfusion starts
within 30 minutes then
the stopped donor heart
has a great chance of
beating again. Hearts recover
very quickly in the
right conditions.
“In the past we’ve
literally had to whip
retrieved donor hearts
from one hospital to the
next. It’s a race against
the clock to preserve the
cold donor heart stored
in an esky full of ice.
“Now we can minimise
damage to the
heart by keeping it warm
and functioning on the
Transmedics OCS. We
can transport it from
hospitals up to seven
hours away.
“There are around
80 heart transplants
performed each year in
Australia, and 25-30 of
these are in NSW. The
average wait time for a
heart transplant is 150
days, so it’s a real breakthrough
to pioneer a
system that allows us to
salvage and optimise donor
hearts.
Dr Granger believes
these types of operations
are a tribute to
team work, communication
and organisation in
the operating theatre.
“Everybody in the
theatre has a critical role
in the retrieval process,
and so far results with
the Transmedics OCS
have been exceptional.
It has increased our
heart transplant rate by
20 percent.
“The fact that we can
travel to virtually any
hospital in Australia
and perform this operation
successfully reflects
upon the wonderful
training and dedication
of all staff involved.
“There is nothing
more amazing than sitting
next to a beating
heart in a box on an
airplane, knowing that
a surgical team and patient
are getting ready to
receive this wonderful
gift.”
DISCLAIMER: The information contained in this publication is published in good faith and has been
derived from sources believed to be reliable and accurate. However, neither the Grey Power New
Zealand Federation Inc. nor any person involved in the preparation of this publication accepts any
form of liability whatsoever for its contents, including editorials, advertisements, opinions, advice
or information, or for any consequences for its use. Grey Power New Zealand Federation Inc is a
non-political organisation with no affiliation to any political party or political group. ISSN 1173-2415