Cardiovascular disease (CVD), which includes heart failure, kills 18.6 million people in the world every year – more than cancer, respiratory diseases and HIV combined.1 Two percent of people in Gulf Cooperation Council (GCC) countries2 will suffer from heart failure during their lifetime.3 Almost 60 million people live in the GCC region, so more than one million people suffer with the progressive disease.
As a result, the number of people requiring organ transplants – including heart transplantation – is growing. According to the Global Observatory on Donation and Transplantation (GODT), the total number of organ transplants globally grew every year between 2010 and 2019, peaking at 157,301 in the year leading up to the coronavirus pandemic.4 Even during the pandemic, 129,681 and 104,659 transplants were still carried out in 2020 and 2021 to meet patient demand. In the Middle East’s most populated countries, Saudi Arabia and the United Arab Emirates, this global trend is reflected too – with more than 2,600 organ transplants (including 81 heart transplants) carried out in the last two years.
Despite heart transplant surgery estimated to cost up to $1.4 million, transplantation remains the most effective treatment for end stage organ failure. But even those fortunate enough to receive an organ match are still faced with substantial burden both physically and financially (through health insurance schemes). Frequent care and monitoring are required before and immediately after surgery, throughout recovery and for the months and years after, contributing significant medical cost to the healthcare system.
Balancing the burden
Transplanting vital organs requires substantial amounts of time and resources, as well as knowledge and expertise. The number of hospital staff required for each surgery is high with transplant surgeons, physicians, coordinators, and dieticians all involved. The patient then spends significant time in a high dependency ICU with further substantial staffing requirements 24-7. If the organ donor has died, expensive medication is needed to keep the organs healthy; if the donor lives far away, chartered flights are required to collect and transport the organs where they need to go.
Even once a patient has undergone transplantation surgery, the burden continues long after they are discharged from hospital. With every transplant surgery, there is a risk that a patient’s body will reject the new organ or develop other complications later in their life. To prevent rejection, transplant patients take immunosuppressive drugs for the rest of their lives. However, such drugs can have subsequent negative impacts on the patient’s overall health, making it harder to fight off infections, potentially boosting the risk of other diseases, such as diabetes and cancer.
There is the cultural attitude towards transplant to consider too. While large numbers of people across the region seem to accept the concept of transplantation and are willing to donate organs, there are still patients who may choose to reject an organ transplant on religious or personal grounds, as well as those that hold some reservations towards heart donation.
In most circumstances, transplantation costs cannot be reduced without the success of the transplant being negatively impacted. It is not possible to, for instance, reduce the cost of the testing and treatment required up to transplantation surgery without risking the condition deteriorating quickly. However, speeding up recovery, and making successful recovery more likely, can help to significantly reduce post-surgical costs.
As more patients require transplantation, the burden on the healthcare system grows – both globally and across the Middle East. Therefore, it is important to explore how innovations in medical technology (MedTech) can positively impact patient recovery and the strain on healthcare resources.
Making recovery more effective with MedTech
Healthcare professionals are beginning to adopt innovative technological solutions to transform post-surgical recovery, helping to improve patient outcomes and make procedures such as organ transplantations more cost-effective.
The concept is simple: if patients spend less time in hospital recovering, move their recovery into the home setting sooner, and reduce complications following surgery, the procedure will cost healthcare systems less money. This would also allow hospitals to care for more patients and free up more hospital beds. But how can this be achieved?
Existing MedTech is already making significant breakthroughs in post-surgical recovery. For example, a randomised controlled trial conducted by Lawson Health Research Institute (LHSC) in Ontario, Canada, found that a wearable MedTech device that increases blood flow in the deep veins of the calf (equal to 60 percent of walking without a patient having to move) helped to enhance post-surgical recovery and shorten kidney transplantation hospital stays by more than one day, while reducing surgical site infections by nearly 60 percent.5
As transplant patients are at increased risk of infections, devices that can reduce infection rates will benefit the patient as well as reduce the financial burden. Devices that can reduce infections while discharging patients earlier have the potential to save thousands of dollars per transplantation surgery.
Opening a new frontier
Surgery is already reaching the frontiers of what is possible – new techniques such as laser surgery and robotic surgery have made procedures more accurate and less invasive. But the gains offered by innovation in surgery are increasingly marginal.
Healthcare professionals are now looking at recovery as a place to innovate, finding new ways to enhance recovery, decrease the length of a hospital stay and – crucially – increase quality of life following surgery. The challenge is finding solutions that are more cost-effective than those that already exist.
MedTech can provide those solutions, especially medical devices that can reduce the rate of infections and time spent in in-patient care for transplant patients. However, for innovation to thrive, greater investment is required in medical device manufacturers to allow for the necessary clinical trials, design developments and regulatory approval to be achieved – all of which take years to complete.
But with the right investments and enough clinical data, innovation has the potential to transform patient recovery and reduce healthcare costs, helping relieve the huge burden of surgery for healthcare systems across the globe.