Change of heart: will advanced therapeutics replace heart transplants?

To mark the 50th anniversary of the first UK heart transplant, Professor Sian Harding looks at the future of transplantation in this post. 


Fifty years ago, history was made at the National Heart Hospital in London with the first heart transplant performed in the UK. Half a century later, transplantation continues to the be the gold standard treatment for a failing heart. However, the growing number of people on the waiting list for a new heart, coupled with the risky and complex nature of the procedure is resulting in scientists exploring alternatives to transplantation. One of these alternatives is gene therapy. (more…)

“You don’t defibrillate asystole…” and other arguments with creatives

Dr Christopher Peters provides an insight into life behind the scenes as a TV medical advisor for leading programmes such as Eastenders and Holby City.


It is a favourite pastime of anyone who works in healthcare to scoff at the mistakes we see when medicine is portrayed on film. From the back-to-front chest X-ray on Scrubs to the miraculous success rates of chest compressions in soaps we love to mock. However, for the last four years I have been working with various TV programmes to try to inject a degree of realism without dampening the drama.

This started with Holby City when I helped out on set, making sure that operating scenes looked realistic and that the actors could pass off as surgeons. This was my introduction to the tension between realism and plot. Being a medical drama, Holby had the budget and resources to try and get things right, but even they couldn’t keep viewers interested if they showed a lovely routine list of day cases where nothing goes wrong! (more…)

Would you give the gift of a kidney to a stranger in need?

 

As far as generous Christmas presents go, donating your kidney seems for many at the extreme end. However, for a few lucky kidney disease patients, this is the gift of a lifetime. Known as unspecified or non-directed altruistic kidney donation, this form of live organ donation is on the rise, and could potentially wipe the waiting list if more stepped forward. I met Frank Dor, a consultant transplant surgeon and Head of Transplantation at Imperial College Healthcare NHS Trust, who has carried out hundreds live organ donations.

The waiting game

Frank receives a phone call notifying him that a kidney from a deceased donor has been allocated to one of the recipients at Imperial. This single kidney is in high-demand as there are around 5,000 people on the UK NHS Blood and Transplant (NHSBT) waiting list for a kidney; some waiting for up to five years. Unfortunately, a few hundred of these will die in the meantime for lack of one.

These patients have chronic kidney disease, meaning they have lost their kidney function so dialysis three times per week becomes the norm. However, life on dialysis is debilitating, difficult and time-consuming. “Dialysis is merely a way of keeping people alive, it’s just a temporary measure that can never fully replace the kidney function,” Frank tells me. “Eventually patients on the waiting list get to a point where they start to lose hope and stop making plans for the future”.

The long-term solution is receiving a kidney transplantation, of which there are two types – living and deceased. Transplantation provides patients with the opportunity for a longer and better quality of life, with patients typically gaining 10-20 years of life compared to dialysis. However, the odds for receiving one are not favourable: there are 1,500 patients on dialysis in Imperial College Healthcare NHS Trust but only around 200 of those get transplanted every year. There is a huge gap between supply and demand nationally and internationally. (more…)