SherpaPak® device allows heart to be preserved in a more natural state
By BECKY GILLETTE
The Baptist Health Heart Failure and Transplant Institute has performed almost 320 heart transplants in its 32-year history. Starting this past September, Baptist Health became the first transplant center in Arkansas to adopt the use of the SherpaPak® Cardiac Transport System (CTS) from Paragonix Technologies that is easier for medical personnel to use to prepare the heart for transport and less damaging to the organ.
Baptist Health Transplant Institute Program Director John Ransom, MD, said given the scarcity of donor hearts, it is vitally important to do everything possible to preserve hearts during transport.
“This device allows us to preserve the heart in a more natural state, ultimately better serving the patient with improved technology,” Ransom said.
The previous method of transporting hearts was in a bag of solution sitting on ice and surrounded by ice.
“The major advantage of this device is that the organ is suspended in a solution and surrounded by the SherpaPaks, which maintain a constant temperature between 4-6 degrees Celsius, which is ideal for the transport of the heart,” said Karol Mudy, MD, heart transplant surgical director, Baptist Health Heart Failure and Transplant Institute.
The SherpaPak® CTS paired with the Paragonix app and web portal provides constant temperature and location tracking with real-time updates to the transplant team, information that is critical for this complicated surgery.
Drs. John Ransom and Karol Mudy
According to a recent report comparing post-transplant outcomes between the device and ice storage, investigators noted a one-year survival rate of 96.4 percent in patients where the Paragonix system was used, translating to an increase of 8.7 percent in one-year survival when compared to traditional ice transport.
Mudy said the heart does not keep beating during transport. It is considered cold ischemic time. The quicker the heart is transplanted into the recipient, the better. Mudy said they try to keep the time to under four hours.
In 2022, Baptist Health transplanted nine hearts as the state's only active adult heart transplant program. The center’s largest number to transplant in one year was 20.
Successful heart transplants can add many years to someone’s life while also improving their functioning and enjoyment of life. “Many of our transplanted patients live a normal, quality life,” Mudy said.
There are currently an estimated 3,400 people in the U.S. waiting on a heart transplant. In 2022, there were 4,111 heart transplants across the country. About one in three transplants were done with the SherpaPak® CTS transport system.
Ransom encourages people to consider signing up to be an organ donor.
“Hearts have always been a precious resource,” Ransom said. “Giving someone else the gift of life is one of the most selfless things a human can do. All it takes is answering one question on your driver's license, ‘Yes’."
There have been concerns about some people having long-lasting cardiac effects after coming down with COVID-19. Ransom said the aging population is currently identified as a greater factor of need than COVID. However, he said we do not yet fully know or understand all of the lasting effects COVID has had on the population.
Baptist Health has the only program in the state offering all advanced heart failure therapies to adults in the state. One other option is the left ventricular assist device (LVAD) device that helps keep someone’s heart beating.
“To us, there are no disadvantages to the LVAD,” Ransom said. “Currently the success rate of LVADs, even though not quite equal, are approaching the success rates of transplant. Both advanced heart failure therapies help save lives and both carry inherent risk. The LVAD is a mechanical pump that helps keep your blood pumping through your body when your native heart is failing. A heart transplant is putting a foreign object in your body, which is naturally designed to reject it. Both are excellent therapies, which give us choices on how to help the individual with the best option at the time.”
Ransom has been performing cardiac surgery at Baptist Health for over 40 years. He became interested in heart transplants in the late 1980s when he saw the need to better help patients in Arkansas. He helped perform the state's first heart transplant in 1989.
As the need kept growing to save these patients, Ransom looked for ways to help bridge the patients to a transplant. In 1999, he implanted the first mechanical circulatory support device (MCS). As the heart failure population started growing, he saw the need to increase the use of MCS devices with bridge therapy and destination therapy. In 2008, he implanted the first HeartMate 2 in Arkansas as a destination therapy for heart failure patients. Then in 2015, seeing the need grow further, Ransom became a part of developing the next generation of HeartMate, the HeartMate 3. As part of this clinical trial, Baptist Health was a Top 5 enroller of the trial and has been instrumental in its development.
For as long as he can remember, Mudy has dreamt of becoming a heart surgeon. “This desire cleared and solidified even more during my clinical rotations while at medical school and in residency training,” he says. “I believe that no single person is more important than the team, learning starts outside your comfort zone, and the single most important trait of a good surgeon is humility.”
For more information about Baptist Health heart health services, call Baptist Health HealthLine at 1-888-BAPTIST or visit Baptist-Health.com.