Hand-me-down heart now in its third body

A PATIENT has received a "third-hand heart" in what is believed to be the first case of serial transplantation of the organ.

The heart, which is now beating in the chest of an Italian man, spent its first 56 years pumping blood round the body of a Swiss woman who died in Lugano in August.

An Italian medical team, headed by Antonio Gambino, a cardiac surgeon, flew to the Swiss town and removed the dead woman's heart on 27 August. With the heart packed in ice, they flew back to Padua and transplanted it into a 52-year-old woman who was critically ill with heart disease.

Lodged in its second owner, the heart performed well and the woman was making a good recovery from the surgery until the fifth day when she suffered a brain aneurysm - a swelling in an artery that burst. She was diagnosed brain dead but her newly transplanted heart was still in good shape.

Mr Gambino had a third patient, a man, waiting and he transplanted the entire heart for a second time. He took with it a segment of the heart from the second donor which had been left in place during the first transplant. A man's chest is larger than a woman's and the extra tissue was necessary to join the female heart to the man's major blood vessels.

The operation, described in The Lancet, the medical magazine, took place on 2 September. Both patient and third- hand heart are functioning well. The man is expected to go home in two weeks, a member of the surgical team said yesterday.

The resilience of the organ and its new owner has surprised specialists. During the two transplants, the heart spent a total of five hours in "cold ischaemia" - a state of suspended animation during which no blood was being pumped through it - without sustaining any obvious damage even though four hours is the recommended maximum.

Mr Gambino said the third patient had received heart tissue from two donors, rather than one.

"It will be interesting to see the characteristics of the response evoked by this immunological challenge," he said. Early signs were good, he said, with tests showing no signs of rejection.