LHSC heart transplant recipient, Raj Mittal is pictured with Cardiac Surgeon, Dr. Dave Nagpal.
September 24, 2026
In a groundbreaking achievement for Canadian medicine, the Transmedics Organ Care System maintained a donor heart’s function outside the body, expanding transplant opportunities for London Health Sciences Centre patient Raj Mittal.
The heart transplant team at London Health Sciences Centre (LHSC) performed a cardiac transplant utilizing the Transmedics Organ Care System (OCS), commonly known as a “heart in a box”, to implant a donor heart that might not have been suitable for transplantation otherwise.
This significant procedure took place in February 2026 and was made possible by access to the provincially acquired Trans Medics Organ Care System Heart technology, specialized training for the team, and years of collaboration with Ontario Health and Trillium Gift of Life Network.
Unlike traditional cold storage methods that keep organs on ice during transport between hospitals, heart in a box systems revive donor hearts that have stopped beating after circulatory death. It keeps the heart warm and pumping while providing the transplant team with real-time information about its function and suitability for transplantation.
This technology enhances organ quality preservation and extends potential transport time up to 12 hours, allowing donor hearts to reach recipients who are farther away than before.
“This is a great example of the profound impact advancements and investments in technology can have on patients and their families,” says Dr. Dave Nagpal, Medical Co-Director of the Multi-Organ Transplant Program and Director of Cardiac Transplantation at LHSC. “With this technology we can now transplant organs that might not have been medically suitable otherwise. This gives patients on the organ donor waiting list a greater chance of receiving a lifesaving transplant and better allows teams to honour the wishes of donors and their families to generously give the gift of life.”
For Raj Mittal, his transplant followed a year filled with serious health challenges. In June 2025, while working in his backyard, he experienced chest pain. His wife called 911, leading him to LHSC where he suffered cardiac arrest and underwent triple bypass surgery. He faced complications like pneumonia and kidney problems, spending weeks between intensive care and inpatient units before being discharged in September. At that time, his medical team mentioned he might eventually need a heart transplant.
After another hospital stay in January this year, Mittal had two choices: an LVAD or a heart transplant. After doing some research along with discussions and careful thought with his wife, they decided to go ahead with a transplant option which placed him on the provincial organ donation waitlist. Just two weeks later came the call about an available donor heart.
Once they accepted the donor offer, Dr. Rashmi Nedadur led a recovery team from LHSC to where the heart had been retrieved and placed on the OCS machine. While it was still beating within this system, it was assessed for viability before being transported back to LHSC.
“The quality and function of the heart looked great when we arrived,” says Dr. Nedadur. “When we implanted the heart, it took off immediately.”
Heart transplantation requires precise coordination due to its time-sensitive nature. While one group works on retrieving and assessing the donor organ, another prepares the recipient for surgery.
During implantation surgery, surgeons examine how well-suited the donated heart is while adjusting major vessels so they fit properly within the recipient’s anatomy before carefully sewing it into place. The surgical team protects it throughout using special solutions along with temperature control measures. After positioning it correctly inside Martin’s body, they warm him up again as they restore normal blood chemistry before gradually transitioning circulation duties from machines back over to his new heart.
The impact of Mittal’s successful operation has been nothing short of transformative for him; just one day post-surgery he was already moving around in ICU! Within days he moved into recovery at their dedicated unit but needed additional monitoring-alongside brief returns back into intensive care-to manage blood pressure levels fluid levels until discharge later that month; since then he’s continued improving steadily!
“I am improving every day,” says Mittal. “Before I could hardly move at all-I spent my days either sitting or lying down without being able socialize much-but now my energy has come back! I’m walking around more often enjoying quality time spent family members together again-thanks entirely due largely towards having received this incredible gift through my recent Heart Transplant!” p>
For Dr. Nagpal & everyone involved here at LH SC , this case showcases just how much teamwork expertise innovation play vital roles advancing both complex cardiac care future possibilities surrounding transplantation overall. p>
“There are many details nuances concerning procedures relating specifically toward transplants themselves however ultimately what matters most remains ensuring protection surrounding any given Donor Hearts whilst maximizing chances success outcomes amongst respective Recipients ,” shares Dr. Nagpal.”Having access such technologies marks important step forward regarding fields related specifically toward organ donations transplants.” p>
This historic cardiac operation builds upon established excellence cultivated via long-standing practices implemented within LHS C’s Multi – Organ Transplant Programs , home longest running Heart Transplant Programs found anywhere across Canada ; providing fresh hope patients awaiting expanded options when considering potential future donors ! p>
Members ofthe cardiactransplantteam are pictured alongsidehearttransplantr ecipient Raj Mitt al. p>
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