National Taiwan University Hospital recently completed the world’s first heart transplant with "zero ischemia time," saving a 49-year-old woman, Ms. Su, who suffered from dilated cardiomyopathy. After repeated hospitalizations for heart failure and the installation of a ventricular assist device, she was re-admitted due to severe infection and placed on the transplant waiting list at National Taiwan University Hospital. On August 15 of last year, the transplant was performed using a mobile perfusion system to transport the donor’s heart, keeping the blood flow and heart beating, aiming to improve the recipient’s post-surgery heart function and survival rate.
Nai-Hsin Chi, an attending physician at the hospital’s Cardiovascular Center, explained that traditionally, the "ischemia time" refers to the period between the removal of the heart from the donor to its implantation in the recipient, with the heart continuing to beat. Generally, ischemia time should not exceed 4 hours to ensure a good prognosis, with shorter times being preferred. While Stanford University Hospital in the U.S. and Guangzhou, China have reported similar cases, they did not achieve "zero ischemia" time.
Chi noted that zero ischemia time prevents the heart from stopping during transplantation or sustaining damage due to blood re-perfusion. To achieve this, the team designed a perfusion system that maintained blood circulation and kept the heart beating from the donor to the recipient’s operating room. The heart was then stitched into the recipient while still maintaining blood flow, making the suturing process more complex. The team plans to continue improving the perfusion system, with hopes of applying this technology to more patients in the future.
Ms. Su, who had a history of heart failure, began experiencing frequent relapses in 2023, requiring regular hospitalization for heart medications. After a ventricular assist device was installed, she was re-admitted in 2024 due to infection. She expressed gratitude for the donor’s generosity and the medical team's help. Within a week after leaving the ICU, she was already able to walk normally, walking for 30 minutes without stopping and even climbing four flights of stairs in one go.
Chi added that National Taiwan University Hospital has performed 700 heart transplants to date, accounting for one-third of all heart transplants in Taiwan. He expressed thanks to the donors and their families for their selflessness, stating that the medical team views their work as a mission. Shu-Hsun Chu, director of the hospital’s Cardiovascular Surgery Department, reported that the five-year survival rate for heart transplant patients at the hospital is 75%, with 40% of patients returning to work and contributing to society.
Ming-Shiang Wu, the hospital’s president, stated that the late heart transplant expert Shu-Hsun Chu had completed the first heart transplant in Asia at National Taiwan University Hospital. He added that the hospital aims to be a pioneer in medical service research and technology. Wu emphasized that ischemia affects heart function, and the team’s breakthrough has been published in top international journals. He hopes that discussions on healthcare will not only focus on issues like insurance and emergency room congestion but also on positive news, noting that the medical team at National Taiwan University Hospital continues to progress despite challenging circumstances.
Resource: 全球首例！台大醫院「無缺血時間」心臟移植 救回4旬女
