Lorraine Sheren said she and her husband are grieving the loss of their 40-year-old son, but are comforted by knowing his unconventional thinking allowed him to donate his heart.
According to his parents, Robbie Sherren was a Special Olympics bowler, Trekkie and computer whiz who went to the emergency room on April 25 with just a sprained ankle, which led to him collapsing in the ER, stopping breathing and suffering an aneurysm and nearly 100 mini-strokes.
Robbie's mother was devastated when doctors initially told her he couldn't donate his heart, because she knew how much it meant to him – he'd been donating blood for decades.
“He was a special person with an infectious smile,” she said.
“He was well-liked and he stayed out of trouble,” his father, Dirk Schellen, said of his red-headed son, who chose to live at home with his parents.
Typically, in Canada, heart donation is only possible in cases of brain or neurological death, where the heart continues to beat after the patient has been declared dead.
But a few hours after that initial “no,” while Robbie was still on life support, the Kingston chapter of Trillium, Ontario's organ and tissue donation organization, stepped in with an idea: If the heart had stopped, they could remove it, feed it blood, and keep it warm, beating, oxygenated, and nourished to keep it viable while they transported it in a special resuscitation box to a recipient.
The technology exists, but Canadian hospitals don't have it, so Kingston Hospital contacted a team of surgeons from the United States and asked them to bring the equipment north for the procedure.
When Robbie died on May 7, he became the first Canadian adult to donate his heart after cardiac or circulatory death (DCD). Kingston Health Sciences Centre.
Robbie's heart was sent to an American transplant recipient, details of which have not been released to protect the recipient's identity.
“Donations have helped us come together and get through this loss,” her mother said.
Dr Gordon Boyd, an intensive care physician and neurologist at Kingston Hospital, treated Robbie and praised his patient and his parents for the work he has done.
“He died in intensive care with his family by his side,” Boyd said, fighting back tears as he recalled his parents telling Robbie to let go.
Boyd said doctors follow strict criteria for organ donation after brain death, including making sure the pupils are fixed and dilate when light is shone into the eye. Robbie's pupils were intermittent, meaning he will likely never recover from brain damage, but he doesn't qualify for organ donation, Boyd said.
The parents decided to discontinue life-sustaining treatment. According to the hospital, in cases of cardiac death, the heart usually stops beating and tissue damage becomes too severe due to lack of oxygen, making the patient unsuitable for donation.
TransMedics' Heart-in-a-Box technology changes this by keeping the heart beating and oxygenated, extending the time between organ removal and transplant.
The Andover, Massachusetts-based company holds a patent for a cardiac organ care system that took 20 years to develop. Australia This is the first time this technique has been used in DCD heart transplantation. In 2014.
Boyd said Robbie has “lit a fire” that could mean DCD eventually becomes routine in Canada.
Heart transplants could increase by nearly 30%
Dr. Vivek Rao, surgical director of the heart transplant program at Toronto's Peter Munk Cardiac Centre, said the first human heart transplant, performed by Dr. Christian Barnard in 1967, was also a DCD.
This approach was abandoned for 40 years until the advent of the heart-in-a-box technique, now used in parts of Europe and the United States.
In 2023, researchers reported results from a DCD transplant pilot program in the UK, which showed an increase in overall heart transplants with DCD donors. 28 percent.
After 30 days, DCD transplant recipients had the same survival rate as those who received traditional heart donations.
Heart beating on plane to US transplant patient
Rao is working to bring the Heart-in-a-Box technology to Ontario.
“We performed 43 transplants last year,” Rao said, “and with the adoption of DCD procurement technology, we expect our transplant program to expand well beyond 50, perhaps closer to 60, transplants per year.”
Rao said delays caused by the COVID-19 pandemic emergency meant that the team was only ready to train in using the Heart-in-a-Box technology in January. Then, he said, state procurement policies regarding the technology put it on hold again. They are still waiting for the equipment.
Rao said that if they had been adequately equipped and trained, “all three hearts procured last week would have been delivered to Ontarians.”
Ontario Health said in a statement that it has partnerships and reciprocal agreements with organ donation networks based in other Canadian provinces and the U.S. Donated organs are shared based on the most urgent need.
“The heart-in-a-box approach was a collaborative opportunity for Ontario physicians and clinicians to observe and learn from an experienced U.S. organ harvesting team equipped with specialized equipment,” the agency said.
Motivated families make a difference
Dr. Sam Chemy is an intensive care physician in Montreal who is also an organ donation adviser for Canadian Blood Services.
“Kingston's story shows that motivated families can move the system forward,” Shemmy said.
Chemie said the technology will be used quickly in Ontario and will likely be used in other provinces to help save lives.
Rao hopes to resume training within the next few weeks.
As of Dec. 31, 2023, there are 118 Canadians waiting for a heart transplant, according to Canadian Blood Services, which helps coordinate blood donations and transplants across provinces.
Lorraine Schellen said her son's tradition of giving began as early as possible. [to donate blood] As a birthday present to himself,” she said.
She said last Saturday was her 122nd blood donation.
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