World's first continuous beating heart transplant

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For the first time ever, surgeons at National Taiwan University Hospital (NTUH) successfully performed a heart transplant in which the donor organ never stopped beating. This revolutionary procedure eliminates the traditional pause in blood flow, known as ischemic time, dramatically reducing damage to the heart muscle and improving the chances of a successful transplant.

By keeping the heart continuously pumping oxygenated blood throughout the entire process, NTUH has set a new benchmark in cardiac surgery that promises better outcomes for patients worldwide.

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Traditional heart transplants rely on cold storage, which pauses blood flow to the organ. Even a few hours without oxygen can damage heart muscle, raising the risks of rejection or complications post-surgery. NTUH's method? A custom organ care system that acts like a portable life-support machine, delivering oxygenated blood to the heart from donor to recipient; no pauses, no cold storage.

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Inspired by ECMO life support, NTUH's organ care system keeps the heart pumping outside the body using a system of pumps, oxygenators and reservoirs. During the first surgery, the team transported a donor heart between operating rooms while it was still beating, hooked up to this device. The recipient, a 49-year-old woman with dilated cardiomyopathy, recovered smoothly and showed remarkably low cardiac enzyme levels, which is a key indicator of heart muscle health.

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While Stanford University pioneered "beating-heart" transplants in 2023, their method still included brief ischemic periods (10-30 minutes) during organ transfer. NTUH's zero-ischemic approach? The heart never stopped, not even for a second.

"The hearts were still beating before procurement, continued beating after procurement and never stopped," said Chen Yih-shurng, head of NTUH's organ transplant team.

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With two successful transplants under their belt, NTUH aims to refine the organ care system and expand access. Their groundbreaking findings, published in the Journal of Thoracic and Cardiovascular Surgery Techniques, could redefine global transplant protocols. As demand for donor hearts outpaces supply, this innovation offers hope for shorter wait lists and healthier recoveries.

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NTUH's milestone isn't just about technical prowess, it's about saving lives. By cutting out ischemic time, they've turned "impossible" into "I'm possible." For patients awaiting transplants, this breakthrough means stronger donor hearts, fewer complications and a brighter shot at a second chance. As the team puts it, zero ischemic time equals zero unnecessary risks.

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