At MGH, Building from the Skeleton of a Heart

By Toni Waterman

March 28, 2012

jeffrey mascena's heart

Jeffrey Mascena's diseased heart is now being stripped of its cells — possibly to be regrown.

> > See other stories in WGBH News Focus: Health Care on Trial

BOSTON — Today, the Supreme Court enters its third day of historic arguments over President Barack Obama’s new health care law. A much-championed part of that law requires insurers to provide coverage to people with pre-existing conditions. That’s good news for people with heart failure who need a heart transplant to survive — like Jeffrey Mascena, who was part of research at Massachusetts General Hospital that's aiming to make a patient's damaged, diseased heart new again.
Mascena sat in flannel pajama pants and a blue T-shirt as his cardiologist, Dr. Kimberly Parks, walked into his hospital room at MGH.

mascena new year's
Mascena has spent more than one New Year's Eve in the hospital.

She took Mascena's hand. “So the big day is coming — the big day is discharge day,” she said.

It’s news Mascena had been waiting to hear for years: a one-way ticket out of the hospital.

A new heart on Valentine's Day
Once an avid biker and motorcyclist, Mascena couldn’t even walk his rescue dog Sean two months ago. Heart failure had kept him in and out of the hospital for years — sometimes for months at a time.
“Every Christmas, every New Year’s for the past 5 years or so, I’ve been in the hospital. What’s that do to the rest of your life?” Mascena said.  
Nothing seemed to help him — not a pacemaker, not a heart sensor. So when Mascena landed back in the hospital last December, Parks told him there was only one option left.

heart skeleton
The skeleton of a heart. See larger photo. (MGH)

“We realized that Jeff was not going to survive for more than several months unless we did something drastic. And at that point, we decided he needed a heart transplant,” she said.
Mascena received a new heart on Valentine’s Day. He’s one of roughly 57,000 Americans who’ve received a heart transplant in the last 45 years. The surgery is nothing new, but what’s happening to his heart now, after surgery, is. Doctors are trying to regrow a new, healthy heart from Mascena's diseased, damaged one.

The skeleton of a heart

Here’s how it works.
Since Mascena's heart was ex-planted back in February, it's been sitting in a white Tupperware-like machine in an MGH lab. The machine makes a soft, pumping noise as it gently strips away the heart’s cells until all that remains is a ghostly, translucent heart skeleton. Once the skeleton is created, it will be injected with Mascena's stem cells. Doctors hope those stem cells will populate the heart skeleton, creating a new heart.
“There’s potential in the future that if we were able to reconstruct an individual’s heart, they could be placed on a total artificial heart for a period of time while they’re waiting for their new heart to be regrown,” said Parks.  
It would mean no more waiting for months on a donor list. Your own heart could be refurbished, then re-implanted. Parks said that’s still a long way off, but important benchmarks have already been met on the road to getting there.
Dr. Harold Ott is one of the lead researchers on the project at MGH. He’s already refurbished a rat heart.
“We were able to generate little hearts that performed a little heart function right now — not enough pump function to replace the existing heart but it’s a first step in the right direction,” said Ott.

Mascena dog walk
Mascena and his dog.

The need for new hearts

Ott said if he can get it to work in humans, it would be a game-changer in organ transplantation. Right now, 100,000 Americans are eligible for a heart transplant, but just a little over 2 percent, or 2,300 people, will get one this year.
“That’s what we’re trying to tackle,” said Ott. “Instead of providing these patients with a donor organ from a different person, we try to regrow organs on demand. We could go take a biopsy, go to the lab and try to regenerate new heart muscle that could be implanted similar to a donor organ.”
Ott said it wouldn’t stop there. This process of washing and regrowing has the potential of working on other commonly transplanted organs too.
“So we try to apply this technology to develop lungs, hearts, kidneys, and livers and pancreas in order to face end-organ failure,” said Ott.
As for Mascena, he’s back home now for the first time in three months, slowly getting back into a normal routine. He said his small donation to Ott’s research is his own simple way of paying it forward: “I really hope to make it worthwhile for somebody at some point.”

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