Organ Transplantation and Mechanical Heart

Organ transplantation maybe the treatment for end-stage disease. This would require careful assessment, and meticulous monitoring of the transplanted organ to ensure healthy state and prevent rejection. IJN performed Malaysia’s first heart transplantation in December 1997, Malaysia’s first lung transplantation in December 2005, first double lung transplantation in October 2007. To date, IJN has performed 22 heart transplantation, 5 lung transplantations and 3 heart-lung transplantations.

Organ donors are hard to come by and hence the need for mechanical heart, as a bridge to transplantation. IJN performed Malaysia’s first mechanical heart implantation in July 2005.The first system was the Thoratec IVAD/PVAD system, and a total of 6 patients received this system. In 2010 and 2011, IJN introduced 2 new mechanical heart systems for patients suffering from end stage heart disease. These states of the art systems are sleek and smaller designs that allow patients to be fully mobile but at the same time receiving full circulatory support.

These new systems are designed to support patients on the heart transplant waiting list or for as a destination therapy. Unlike previous mechanical heart support systems, these devices weight less than 1 kg, are easily transportable and gives the patient the freedom to mobilize and continue doing their daily activities. These newer, lighter systems are the Heartmate II and the Heartware.

The THORATEC Heartmate II

IJN introduced these FDA approved device in 2010 and currently a total of 4 patients have been implanted with the Heartmate II system. 2 of them have returned home and returned to work.

The HeartMate II is an axial flow pump that is implanted in the left ventricular apex and provides up to 10 liters of flow back to the aorta.

The HeartWare HVAD system was introduced in IJN in early 2011 and currently a total of 3 patients have been implanted with this system. Malaysia is the first country in Asia to have implanted this system. It’s a centrifugally driven pump and allows up to 10 liters of circulatory support. It’s extremely small and compact size is suitable for the Asian population.

IJN hopes that with the introduction of such systems, it is able to provide a comprehensive therapy for patients suffering from heart failure. Patients whose condition are worsening while waiting for heart transplant can now be offered this “bridge to transplantation” therapy.

At the same time patients who are not suitable candidates for heart transplantation can have the option on being on permanent circulatory support with these two new systems.