Global Health Asia-Pacific March 2020 | Page 30

Heart News First ‘reanimated’ heart transplant takes place in US Method keeps heart functional after donor’s death and could increase the number of organs suitable for transplantation A new method of “reanimating” donor hearts from those who have died from cardiac failure is currently being tested in the United States. A heart transplant team at Duke University Hospital became the first in the country to transplant an adult heart into a recipient through a process known as donation after circulatory death, or DCD. Duke is one of five centres American health authorities have given approval to perform DCD heart transplants as part of a recently launched clinical trial of a device to circulate warm, oxygenated blood through organs. Traditionally, heart donations have depended on a declaration of brain death. Donation after circulatory death occurs after the heart has stopped beating and the person’s death has been declared. DCD transplantation is done regularly in the US for organs other than the heart, though DCD heart transplants have been conducted in Europe and Australia. “This procedure has the potential to expand the donor pool by up to 30 percent,” said Dr Jacob Schroder, surgical director of Duke’s Heart Transplant Program, in a press release. “Increasing the number of donated hearts would decrease the waiting time and the number of deaths that occur while people are waiting. “It’s important to conduct this clinical trial to determine whether those outcomes are realised. We’re grateful for the courage and generosity of both the donors and recipients,” he added. The DCD heart transplantation milestone took place in January after a donated heart was deemed viable for transplant. The recipient, a military veteran, is reported to be recovering well. 28 MARCH 2020 New evidence that diabetes drug can raise risk of heart attack While still on the market, rosiglitazone, or Avandia, is already banned or restricted in many countries A rigorous study has confirmed that the drug rosiglitazone given to diabetes patients can raise the risk of heart attack by 33 percent. Approved by the US Food and Drug Administration in 1999 under the brand name Avandia, it was originally developed to treat type 2 diabetes. Though its use has been restricted in the US and suspended in Europe due to concerns about its harmful effects on heart health, research into its safety had hitherto yielded mixed results. Given the large number of patients treated for diabetes across America, drugs with even modest cardiovascular risks can have major public health implications. Seeking a definitive answer, Yale researchers used the most reliable data available to investigate the effects of the drug on cardiovascular health. Using individual patient records from 33 clinical trials, a team from the Department of Environmental Health Sciences at the Yale School of Public Health examined the outcomes of “acute myocardial infarction, heart failure, cardiovascular-related death, and noncardiovascular-related death.” Their analysis revealed a 33 percent higher risk of cardiovascular death for people who were taking the drug, compared with people who were taking another control substance, including placebo. “The results suggest that rosiglitazone is associated with an increased cardiovascular risk, especially for heart failure events,” the researchers concluded in The BMJ. “Almost 20 years after the drug was approved, uncertainties still exist among patients, clinicians, and policy makers about the effect of the drug on the risk of myocardial infarction.” GlobalHealthAndTravel.com