The United States is experiencing a serious shortage of donor hearts, with only approximately 5,000 heart transplants performed each year. This lack of availability may be especially relevant today as there are nearly 50,000 people around the world living with end-stage heart failure. This situation has only gotten worse over time as the population has aged. At present, more than 6 million Americans are living with heart failure, a number swiftly on the rise.
In the US, the organ transplant system is an “opt-in” model. This means that people need to do something to intentionally decide to be an organ donor. This is in sharp contrast to our friends in England, Scotland, and Wales. Over there, they run an “opt-out” system, where everyone is a donor unless they actively decide they are not. Experts say this very structural difference is part of the reason why the donor shortage is becoming more dire.
Beyond the design of the system itself, several other factors are complicating heart transplantation in the United States. Adding on to that is a complicated mix of in-office treatments and surgical procedures. Late referrals for heart transplants pose further substantial barriers, complicating timely access even more for many patients. All of this is exacerbated by the fragmented nature of the U.S. organ transplant system.
Each day, an average of 13 people in the United States die waiting for an organ transplant of any kind. World-wide, an average of 20 people die each day while waiting for an organ of any kind. Today, more than 3,000 adults and 400 children await heart transplants on lists—just in the United States.
With this crisis in mind, researchers are seeking creative remedies. One exciting advance in this area is the fabrication of EHM patches. These patches have been successful in animal studies with rhesus macaques. These patches consist of lab-grown cardiac tissue made up of as many as 200 million cardiac-derived cells embedded in a collagen hydrogel. If clinical trials substantiate their favorable preliminary findings, these patches would represent a seismic shift in heart failure treatment. Or they could even obviate the need for transplants at all!
Last year’s Dr. Sounok Sen, MD, wants students to understand how transformative an act of organ donation can be in communities. He stated, “If I had to pick one thing we can show our communities, it’s the kind of amazing transformation that organ donation does to a single person in that community.” This comment underscores just how personal the organ donation experience is for those who are waiting – and dying – for a transplant.
As research continues the search for solutions to the lack of available heart transplants goes on. Additional EHM patches make for thrilling stuff for CHF_type cardiac care. If so, they might present a hopeful new option for those wrestling with heart failure. They can help alleviate pressure on an already stressed U.S. organ transplant system.
Research into these micro-reserves is making big strides. At the same time, health systems should be addressing the root causes that create a donor shortage in the first place. The current system’s complexities and late referrals need to be addressed to make sure patients are getting the appropriate level of care when they need it most.
Another concern to patients is the risk of complications from their current treatments. Harding explained that patients develop chronic infections from the intravenous lines implanted during treatment for advanced disease. “You can get chronic infection from the lines,” he explained, highlighting yet another reason for seeking alternatives like engineered heart patches.
In addition, patients are often burdened with logistical obstacles associated with complex treatment regimens. Harding added that current technologies tend to be “things you need to transport and use yourself, and recharge yourself. Such requirements can make everyday life even more challenging for people who are already struggling with life-threatening illnesses.
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