The rise of the machines

I am very interested in the future development of heart transplant technology for a very selfish reason. If and when I get a new heart, chances are it will not continue pumping for a terribly long time. Undertaking a heart transplant saves the recipient's life, but brings into play a myriad of risks and potential complications.

First and foremost, there is a real risk that the body will reject the new organ. It is, after all, a foreign object and the immune system is designed to seek and destroy all foreign objects within the boundaries of its kingdom.

This means that, post transplant, I will need to take powerful drugs every day of my life to suppress my immune system. These drugs will, hopefully, politely but firmly tell my little army of immuno-warriors that the new heart is Switzerland and a no go zone. Hopefully they will listen. However, we aren't clever enough yet to quarantine a particular organ and allow the immuno-warriors to maintain their watch across the rest of the kingdom. The whole army is scaled back everywhere, forever. This means that I will be hypersensitive to all infections, pathogens and any other nasty organisms I may have the misfortune to meet after the transplant.

Then, even if I manage to defeat the combined forces of Rejection and Infection, the new heart will not necessarily endure for the term of my natural life. It will wear out more quickly than its pals like my liver, spleen and kidneys, just because it isn't mine.

Rejection, Infection and Organ Expiry are the three horsemen of the apocalypse that bring down many of those who are lucky enough to get an organ transplant. So far as heart transplantees are concerned, roughly 75% live for a further five years post transplant and around 56% get to ten.

Anyway, I have booked a ticket on the ten year plus train so no need to worry. I am young(ish) and fit (well, fit in a pudgy lawyer sense) and should fall into the good end of the bell curve. Fiona Coote is still going strong after twenty five years. No reason I can't either.

The stats don't make me feel melancholic or morbid. In fact, I look forward to the future with great optimism. This is because heart transplant technology is developing rapidly. I have seen the future. Its developers are not confined to the States or Europe, where many research centres are doing fine work. A little group of doctors and engineers here in Brisbane, in my own hospital in fact, are developing what is presently the world's best artificial heart. This is what my doctors do in their spare time!

The artificial heart being developed by these clever chaps is different to the artificial hearts that have been designed, and used, thus far. The idea of an artificial heart is not new and for many years last resort patients have been fitted with them, with limited success.

The Brissy boys have developed an artificial heart that replicates the function of the human heart, but not the method. It doesn't look like a heart and it doesn't pulsate intermittently. It is a little cylinder that receives blood into the top, spins it round in an internal spinning wheel, shoots it out to the lungs to be oxygenated and then pumps it through to the aorta. It is powered by electromagnetic forces and is charged from an external power source without the need for wires or tubes going through the skin. A bit like bluetooth. The flow is continuous so the patient will have no pulse. Spooky.

If the project works, there will be no waiting lists, no transplants of live organs, no rejection, no added risk of infection and no organ wear. The transplant team will just take a heart of the right size off the shelf and bang it in.

The cardiologist leading the research is a bloke called John Fraser. He is an enthusiastic and charismatic  Scotsman who has done a bit of acting. He once shared a flat with David Tennant, who recently played Doctor Who. My wife and daughter like Mr Tennant very much, so Dr Fraser is a popular man in our household.  He has told Imogen that homework was a waste of time. She continues to do her homework, but with great reluctance. She said, "Dad, he knows David Tennant and is making you a new heart. Do you want to argue with him?"

Feel free to donate bucketloads of cash to the Prince Charles Hospital Foundation to support this research. Have a look at the website, Bivacor.com, where the lads explain their work a little better than I have attempted to do. The artificial heart has just been implanted into some noble sheep and should be ready for putting into patients in around five or so years. It may well be up and running at the time I'll be up for a new engine myself.


Until next time,