A World First in Heart Transplantation
On April 9, 2025, National Taiwan University Hospital (NTUH) successfully performed the world’s first zero-ischemia-time beating-heart transplant, marking a historic moment in modern medicine. This breakthrough procedure kept the donor heart beating and perfused with oxygenated blood at all stages—from donation to implantation—thereby eliminating the typical damage caused by interrupted blood supply.
What Makes This Procedure Different?
Traditional Transplants vs. Beating-Heart Transplantation
In conventional heart transplants, the donor heart is temporarily deprived of blood supply (ischemia), which can lead to ischemia-reperfusion injury (IRI)—a key factor in early graft dysfunction and long-term complications. In contrast, the new technique, known as Ischemia-Free Beating-Heart Transplantation (IFBHT), completely avoids this risk.
Normothermic Machine Perfusion: The Game Changer
To achieve this, NTUH used normothermic machine perfusion (NMP), which kept the heart warm, oxygenated, and functioning throughout the entire transplant process. Remarkably, this is the first time a heart has been transplanted without ever stopping.
Clinical Outcomes: A Strong and Beating Success
During the procedure, the donor heart maintained a stable rhythm and healthy ventricular function while outside the body. Following implantation, the recipient’s heart function was reported as excellent, with an ejection fraction of 70%. Moreover, the patient was discharged just 20 days later and has shown no complications during an eight-month follow-up.
A Global Leap in Transplant Medicine
This advancement is not only a triumph for cardiac surgery, but also a step forward in expanding the donor pool. Because the procedure eliminates ischemic damage, it could make previously unsuitable hearts viable for transplantation. Additionally, IFBHT aligns with similar innovations in ischemia-free liver and kidney transplants, which have already shown improved outcomes.
