A medical team at National Taiwan University Hospital reports that they’ve completed the first beating heart transplant—a procedure in which a donor heart experiences no reduced blood flow during surgery, thereby avoiding potential tissue damage during transplantation.
The work is an improvement on a previous milestone, achieved by Stanford University in 2023, which drastically limited the amount of time a heart needed to be stopped during the procedure.
Because the heart continues functioning during the entire process, the medical team expects this technique to raise the success rate of heart transplantation—a welcome breakthrough, as demand for hearts currently outpace supply.
In the U.S. alone, nearly 3,800 people are on the waiting list for heart transplant, but as Yale Medicine notes, demand for healthy hearts currently outstrips supply by a significant margin, leading many people to suffer for months with failing hearts. To help ease the stress on this biological ‘supply chain,’ scientists have turned to new methods to ease the suffering of those waiting for hearts while also ensuring that surgical success rates climb ever upward.
Earlier this year, St. Vincent’s Hospital Sydney in Australia reported that a man survived 100 days with a titanium heart while waiting for a donor heart to become available. And now, a medical team at the National Taiwan University Hospital (NTUH) claims to have performed the very first “beating heart” transplant, meaning that the donor heart never stopped beating during its removal, connection to support system, and surgical transplantation. The results of the procedure were documented in a paper published in the Journal of Thoracic and Cardiovascular Surgery Techniques
“The system comprised a heart box, reservoir, centrifugal pump, oxygenator, and perfusion tubing,” the authors wrote in a pre-proof of the paper. “It enabled continuous normothermic diluted donor blood myocardial perfusion from donor explantation to recipient implantation.”
The major breakthrough is that the donor heart—which came from a 35-year-old male who experienced brain death after complications during cerebellar tumor surgery—never experienced cardioplegia (a stoppage of the heart) or ischemia (reduced blood flow). Both of these complications can damage the organ during the transplant process and cause issues down the road.
Previously, teams from Stanford University (the university where the first U.S. heart transplant was performed in 1968) had also published studies claiming that they performed beating heart transplants back in 2023 and 2024. But the Taipei Times reports that those procedures still required very brief ischemic time between removal and being hooked up to a “heart in a box” support system.
“We wanted to perform a heart transplant without any ischemic time so that the heart wouldn’t have to stop, and we could also avoid injury [to heart tissue] that typically occurs after reperfusion,” Chi Nai-hsin, an attending physician at NTUH, said during a press conference in Taipei. “We have demonstrated the safety and feasibility of the surgery.”
Post-transplant—during which the heart continued to beat during the entire process—a 49-year old who was experiencing end-stage heart failure is alive and well. With this technique, doctors and scientists hope to see less tissue damage during transplantation, which in turn should tick up the success rate of heart transplants overall. That’s certainly good news for the tens of thousands of people around the world waiting for a new heart.
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