‘Heart in a Box:’ Technology Expands Access to Organ Transplant

Because the need for heart transplants is greater than the supply of available hearts, Yale Medicine surgeons are constantly searching for ways to safely expand the pool of viable organs, including using hearts from donors whose hearts have stopped beating (as opposed to those who are brain-dead but still have a beating heart). One way to do this is through a new type of technology from TransMedics Organ Care System called “heart in a box.”

It's not actually just a box, of course. After a heart is removed from the donor, it is placed in a perfusion machine that restarts the heart and keeps blood flowing through it while it is transported to the donor recipient.

“The heart is beating. Blood flow is restored using blood from the donor,” explains Christopher Maulion, MD, a Yale Medicine advanced heart failure and transplant cardiologist.

“This allows the organ to be at the same temperature as the body, and it can beat freely. The ‘heart in a box’ system also allows for reassessment of heart function after it has begun the process of, essentially, stopping and dying. What’s more, with this system, we’re able to transport the heart farther distances than we could if we were using cold storage.”

This technology dramatically increases access to hearts, says Arnar Geirsson, MD, chief of Yale Medicine Cardiac Surgery. “And with it, we expect we will be able to grow our transplant program even further,” he says.

In this video, Yale Medicine physicians discuss this new technology and its implications for those who need a heart transplant.