On October 31, 2014, the Dutch Transplantation Foundation an interview with dr. Nicolaas de Jonge of the University Medical Center Utrecht (UMCU) with the title:
The future of transplantation: increasingly smaller supportive hearts
Below are a few key excerpts:
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In 1993 the pumps were still large primitive disks of twelve centimeters in diameter, which lasted no longer than two years. Since 2006, the tubes are only about eight centimeters long and they last longer on average. In fact, one of our patients has been wearing it for five years and one patient in the US for ten years.
The quality of life is relatively good. People can use it to work, cycle, drive and travel abroad. They must take precautions. The batteries on which the pump runs must be charged every eight hours. The patients always wear it in two bags around their shoulders. A further disadvantage is that a cable protrudes from their abdomen that runs to the batteries. That spot in their abdomen is a possible source of infection. In addition, such a device in the body increases the chance of blood clotting. We still see the support hearts as a temporary interim solution. Most patients still receive a donor heart after two to three years.'
Which breakthrough do you expect first and in what time frame?
……..I therefore have higher expectations of those supportive hearts. They are getting smaller. Pumps the size of an AA battery are now under development. You could insert it with minor surgery. In addition, it is being investigated whether a battery can be placed under the skin, which must then be able to be charged through the skin. Then you are rid of a potential source of infection. If the development continues, assisted hearts will become more comfortable for patients and can live with them even longer. I expect those techniques to come on the market in three or four years.'
What effect will this breakthrough have on transplant medicine practice?
'It could well be that the assisted hearts will slowly replace heart transplants. That we first implant a supportive heart in patients with heart failure, and only if it really no longer works, a donor heart. The big advantage is that you can help more patients and plan better. A donor heart always comes unexpectedly, so you can grab a pump right out of the closet, so to speak. The waiting list will therefore be considerably shorter.
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