Royal Papworth Hosptal in Cambridge pioneers world-first technique in child heart transplantation

Staff at Royal Papworth say there remains a worldwide shortage of donor hearts, particularly for children. Credit: Royal Papworth

A collaboration between Royal Papworth Hospital in Cambridges and Great Ormond Street has increased the number of heart transplants for children in the UK by 50 %.

Together they’ve introduced a world-first paediatric heart transplant technique that has successfully expanded the donor pool, with six children receiving life-saving  transplants during the pandemic.

14-year-old Freya is one of six children since Feb 2020 to get the life-saving transplant. Credit: Royal Papworth

The donation after circulatory death (DCD) heart transplant programme was previously only available to adults. 

With these transplants, the heart has stopped beating in the donor and is transferred to a pioneering machine where doctors restart it and keep it beating outside of a human body.  

It’s a technique Royal Papworth have been using since 2015. 

Retrieval nurse Jen with the machine, which is called an organ care system (OCS). Credit: Royal Papworth Hospital

In 2020 the hospital collaborated with Great Ormond Street in London to extend the service to children.

The team at Royal Papworth retrieve the heart and the team at Great Ormond Street implant the organ. 

It’s the first-ever use of the technique in paediatric transplantation anywhere in the world.

It’s been an incredible multi-institutional and multidisciplinary team effort to make this possible, involving everyone from the specialist nurses in organ donation and retrieval, transplant coordinators,, physicians and surgeons. Above all, none of this would be possible without the generosity of every donor and their families.

Marius Berman, Consultant Cardiothoracic Transplant Surgeon at Royal Papworth Hospital
Surgeons Simon Messer and Marius Berman and nurse Jen Baxter are some of the team who do this lifesaving work. Credit: Royal Papworth Hospital

Across Britain there is a shortage of suitable donors, which means that the number of children who would benefit from organ transplantation exceeds the number of organs available.

Children face longer than average wait times due to the difficulty of finding the right match and because the consent rate for paediatric organ donation is much lower than the national average for adults.

 For children who can receive adult-sized hearts, the DCD heart programme is a promising solution to reducing the waiting time.

Jacob Simmonds, who's a Consultant Cardiologist and Transplant Physician at Great Ormond Street says the technique has essentially doubled the number of transplants they can do in eligible patients at the hospital:

With the DCD heart programme we have unlocked more opportunities for donation, essentially doubling the number of transplants done at GOSH in eligible patients weighing over 20kg. It’s game-changing and work is already underway to make the technique suitable for our much younger and smaller patients.

Jacob Simmonds, Consultant Cardiologist and Transplant Physician at GOSH

He also added:

“Ultimately, though, this still relies on families having conversations around their organ donation wishes, and then of course the bravery to consider making this precious, life-saving gift at a time of unimaginable tragedy.”

Royal Papworth Hospital. Credit: ITV News Anglia

The teams at both hospitals are working together  to develop a new machine that will enable DCD heart donation from even smaller infants, which would pave the way for transplantation for babies and young children, where donors are the most scarce.

The collaboration between Royal Papworth Hospital and Great Ormond Street Hospital is saving the lives of children and bringing hope to the families of those children. It has been great to see heart transplants continuing during this pandemic and incredible that lots more children have received a heart compared to the previous year, thanks in part to this collaboration.

John Forsythe, Medical Director for Organ Donation and Transplantation at NHS Blood and Transplant