Waiting list for heart transplant no longer rising due to "heart-in-a-box" method

The number of heart transplants in the Netherlands has increased significantly since Dutch hospitals started using the “heart-in-a-box” transplant technique two years ago. As a result, the waiting list for heart transplants is “stabilizing” after years of increase, the Dutch Transplant Foundation (NTS) reported.

The heart-in-a-box method makes it possible to use a heart that has stopped beating for transplant. The heart is connected to a machine shortly after death. The machine supplies oxygen and blood and keeps the heart beating. The method makes considerably more donated hearts eligible for transplantation. Previously, Dutch doctors could only use a heart that was still beating.

Up to and including July this year, there were 39 heart transplants in the Netherlands, about the same number as the average number of transplants in entire years in the past. ”If we can perform about 60 heart transplants this year, we will easily surpass that number in 2023,” Michiel Erasums, a heart-lung surgeon at UMC Groningen, said in the NTS release.

“Then we will hopefully also see a decrease in the number of people on the waiting list and in the number of people who die before a suitable heart becomes available. We are already seeing a stabilization in the number of people on the waiting list, while it has only increased in recent years. And the results for the recipient patients are at least as good as with the classic heart donation method,” Erasmus said.

According to Olivier Manintveld, a cardiologist at Erasmus MC, the heart-in-a-box method also gives surgeons more peace and time to perform the surgery. “The heart is protected on the perfusion machine. It can be kept for up to eight hours before transplanting. The use of the machine also restores previously unusable donor hearts and makes them suitable for transplantation.”

So far, 60 people in the Netherlands have received a new heart via the heart-in-a-box method. The Ministry of Public Health decided to add the method to the basic health insurance package from 1 January 2024.