Following this pioneering procedure the definition of death previously used – when a heart stopped beating – had to be changed to total brain death. Since that time the procedure has become almost commonplace, with 115 heart transplants taking place in this country in 2004/05.But medical procedures and techniques are continually evolving and nowhere more so than in the field of cardiac surgery. Incredibly, the heart transplant operation has been improved with the introduction of a machine allowing ‘beating heart’ transplants to take place. The first such transplant in this country – and only the fourth in the world using this system – took place this earlier month at Papworth hospital in Cambridge. The procedure places the donated heart in a machine that allows it to continue beating while waiting for a recipient. Original techniques require the heart to be placed on ice and to reach the recipient within four to six hours after being removed from the donor. The time limitations of this system have many drawbacks, in particular when a heart has to travel a long way to get to the recipient and when it takes longer for the diseased heart to be removed than anticipated. The beating heart procedure is revolutionary in that it gives surgeons the time to check the heart’s function for damage and the chance to better match the heart with a suitable recipient. What it may also mean is that hearts that were previously not suitable for transplants could be repaired or treated by surgeons ahead of the procedure. The implications for patients on waiting lists for heart transplants are enormous. Professor Bruce Rosengard, the surgeon who led the transplant team, says the use of this machine could quadruple the number of transplants performed each year. For the families of the 15 people who died in 2004/05 waiting for a transplant it will be of some comfort to know other patients’ loved ones may not face the same fate. If further trials of the procedure go to plan the system is likely to be available next year and it will also be tested for suitability of the transplant of lungs, livers and kidneys. This incredible development again confirms the need for protection as a result of medical boundaries being pushed. The rise in the number of transplants will inevitably result in an increase in the number of survivors. But in surviving, what is the likelihood that patients who have been given this second chance at life are faced with the financial implications of doing so? Pretty high. When you are speaking to your clients, remember how quickly medical procedures evolve and remind them that they are more likely to survive than die from a critical illness. It’s imperative that you make sure your clients are prepared for this possibility and that you do all you can to ensure they understand why it’s so important they are protected. After all, like the rest of us, they don’t know what’s around the corner.
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