Promising new technology may extend the life of a failing organ for patients suffering from heart or lung disease while they wait for a donor organ. The use of stem cells may eliminate the need for a transplant and even eradicate heart disease in patients. Research and discussion will be presented today during symposia at the International Society for Heart and Lung Transplantation (ISHLT) Annual Meeting and Scientific Session in Philadelphia.
Presenter Robert Kormos, M.D., University of Pittsburgh (Penn.) Medical Center, advocates the development and use of a pump device that will address, and in some cases eliminate, heart failure. Partnered with stem cell technology, the new pump would be smaller and minimally invasive and would allow a patient's heart to emerge strong enough to accept the implanted stem cells that would improve the heart's function and reduce or eliminate heart disease in the patient.
"We know from successful trials outside the U.S. that implanting stem cells results in myocardial recovery. By changing our way of thinking and addressing heart failure in its earlier states, and by using devices and stem cells together, a patient can enjoy life without heart failure instead of continuing to live with it," says Kormos.
Kormos also suggests that a new approach for ventricular assist devices (VAD) is on the horizon for cardiac patients. While VAD usage gains increasing acceptance, a new way of thinking may change the way doctors use these assistive devices.
Ventricular assist devices stabilize adults with heart disease, and act as a mechanical "bridge" for patients waiting for a donor heart. According to a Columbia University Medical Center study, patients in end-stage heart failure who received a VAD had more than double the one-year survival rate compared with patients who did not receive a device.
However, Kormos challenges that VADs should be incorporated earlier in treatment. "We in the medical community spend a lot of time helping patients live with heart failure until their bodies can't tolerate it any longer. Ironically, by the time we deem the candidate eligible for a heart transplant or a VAD, the patient may be so sick that he is no longer a good candidate for either, " says Kormos.
Pediatric Devices
VADs are designed for adult patients, but recent studies show that they may also help some children suffering from heart disease. "More than 70 percent of children with end-stage heart disease are bridging successfully to transplantation with a VAD. This emphasizes the need to develop a device for smaller patients who cannot be supported with current technology," says James Kirklin, M.D., University of Alabama at Birmingham and participant in this afternoon's Symposium, "The Final Technology Solutions for End Stage Congestive Heart Failure" at the ISHLT Meeting.
Research on implanting cardiac defibrillators in children will also be presented at the Meeting. Defibrillators help prevent sudden cardiac death and have proven effective for adults with heart disease.