Is it possible to recover a human heart after death?

Is it possible to recover a human heart after death?

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Surgeons often say that when someone suffers a heart attack time is vital.

This organ depends on a continuous supply of oxygen from the coronary arteries. If these are blocked and the supply is interrupted, the heart muscle cells begin to be destroyed in a few minutes.

In many cases, unless surgeons can mitigate that blockage in less than an hour, more than a billion cells are irreversibly lost.

Those who survive, often do so suffering from heart failure that will accompany them for life. In the five years after an attack, 50% of people who suffer from it will no longer be alive.

“Their hearts become so weak that they can not maintain sufficient blood flow and simply end up stopping altogether, ” says Sanjay Sinha, a cardiologist at Addenbrooke Hospital in Cambridge, UK.

But even in the next five years, regenerative medicine can provide a new and radical alternative: the so-called “heart patches“.

The only current option

The challenge is that, unlike other organs such as skin and liver, the heart has a very limited capacity for self-healing .

The muscle cells of this organ reproduce at a rate of only 0.5% per year, which is not enough to repair significant damage.

A man receiving first aid after suffering a heart attack.
Copyright of the GETTY IMAGES imageImage caption Those who survive a heart attack are left with life-long heart failure.

Instead, dead cells are replaced by thick layers of hard, stiff scar tissue, which means that different parts of the heart simply stop working.

At the moment, the only medical option for patients with heart failure is a heart transplant . But the lack of donors means that, for example, in the United Kingdom, only 200 of these operations can be carried out per year.

“I do not think we can ever get the number of donors we need because there are not thousands of young people who die with healthy hearts,” says Sinha.

“It’s a very small group of people who die in traffic accidents or head injuries, and whose heart is still strong and can be used for a transplant.”

Stem cell medicine can offer an alternative.

Scientists have tried to strengthen the muscles of damaged hearts by injecting individual stem cells – which can be transformed into many different types of tissue – directly into the heart from the patient’s blood or bone marrow.

Fridge with organ for transplant.
Copyright of the GETTY IMAGES imageImage caption The number of donors is insufficient to save all people with heart disease.

But while these experiments have successfully regenerated blood vessels that were damaged and have improved blood flow to the heart, they have also shown minimal benefit in solving the main problem: regain lost heart muscle .

It is believed that this is because 95% of the injected stem cells do not bind to the heart and are lost immediately in the bloodstream .

Patches that beat

But along with a team of biologists at the Stem Cell Institute at the University of Cambridge, Sinha is working on a different idea: cardiac patches.

These small fragments of heart muscle – less than 2.5 square centimeters in area and half a centimeter thick – are created in the laboratory.

The patches are formed over a period of one month, taking blood cells and reprogramming them into a specific type of stem cell that can be converted into any tissue in the human body (in this case, heart muscle, blood vessel and epicardium cells). , the membrane around the heart that gives it its shape). 

We are creating fully functional tissue that beats and contracts.”

Sanjay Sinha, cardiologist at the Addenbrooke hospital in Cambridge, United Kingdom

“We believe that these patches will have many more possibilities to be assimilated naturally in the heart of a patient, since we are creating fully functional tissue that beats and contracts combining all these different types of cells that communicate with each other,” says Sinha .

“We know that epicardial cells are especially important in coordinating the proper development of the heart muscle, since research has shown that in developing embryos there is a large amount of cross-communication between the epicardium and the developing heart.” .

Currently, Sinha is preparing the experimentation of the patches. First it will be in mice and then in pigs. If all goes as planned, in five years it could carry out the first test in being human.

In three dimensions

But Sinha is not the only one. In the United States, a team of scientists from the universities of Stanford, Duke and Wisconsin also tries to create patches for the heart.

These doctors also work on a technique for the future in which a combination of ultrasounds and MRIs are used to locate the healed structures in the heart.

Depending on the shape of the scar, they would print three-dimensional heart patch customized with any shape or size. The idea is that surgeons open the thoracic cavity and patch the patch directly to the heart , so that it is attached to existing arteries and veins.

Operation of heart
Copyright of the GETTY IMAGES imageImage caption The new procedure would involve sewing a 3D printed patch directly on the heart.

“For patients with particularly severe heart failure, several patches will be needed in several places as the entire heart dilate to try to adapt to the damage,” says Tim Kamp, a professor of regenerative biology at the University of Wisconsin who is part of the team. equipment.

“His shape happens to be like a rugby ball a big balloon or a basketball .”

One of the main challenges is how to electrically integrate the new patch with the heart to ensure that both beats are synchronized . Any defective electrical connection could cause an abnormal heart rhythm.

“We can put the patch on the heart with our surgical tools, but we can not force them to go hand in hand,” says Kamp.

But we hope they do. We expect that the electrical signals that pass through the heart muscle like a wave and tell it to contract, will cause the new patch to contract at the same rate.”

Millionaire savings

If these challenges are overcome, Sinha believes that not only lives, but also dollars could be saved.

Heart with a band-aid.
Copyright of the GETTY IMAGES imageImage caption This new cardiac patch technique could change and improve the lives of millions of people around the world.

In the United Kingdom, heart transplants cost about US $ 690,000 , including inpatient care. But for the thousands of patients with heart failure who can not get a transplant, the costs for medical care continue and the number of hospital admissions can be even higher.

Instead, it is estimated that the potential cost of a cardiac patch treatment would be around US 96,000 .

In addition, because patches are created using their own blood, patients who undergo the intervention should not experience some of the complications associated with heart transplants, such as taking high doses of immunosuppressant medications.

“A damaged heart is a highly inflamed and hostile place in which new tissues may find it difficult to survive,” says Kamp.

We can put the patch on the heart with our surgical tools, but we can not force them to go hand in hand “

Tim Kamp, professor of regenerative biology at the University of Wisconsin, USA

“The advantage of these heart patches is that they are personalized for the patient, so it is unlikely that the heart will reject them .”

According to the researchers, this technique could change the lives of millions of people around the world.

“Heart failure can greatly incapacitate people, you’re constantly tired, you can not even go up a flight of stairs, ” says Sinha.

“But, for the first time, we believe that we can recreate the actual cardiac tissue that is identical to the patient’s, where the cells communicate with each other in a mysterious and wonderful way and work together as they do in the body.”

“If we can adjust it properly in the coming years and make sure it is completely safe, then I could help these people to lead a normal life again .”

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