In a groundbreaking achievement for Canada, the cardiac team at London Health Sciences Centre (LHSC) has successfully performed a heart transplant using the Transmedics Organ Care system, commonly called “heart in a box.”
This innovative system enabled the team to use a donor heart that might not have been suitable for transplantation otherwise. Dr. Dave Nagpal, co-director of the multi-organ transplant program, explained, “Heart in a box” systems help revive a donor heart that has stopped beating after circulatory death.
“So this technology allows us to take that heart with some donor blood, put it on this machine, and watch the function of the heart, so we make sure that the heart is good enough for use for our recipient,”
The recipient of this donated heart was Raj Mittal. He had triple bypass surgery in 2025 and was readmitted in January of this year when he was given the option to join the organ donation list. He underwent his transplant surgery in February 2026.
“I am able to do some activities like walking, and as per the doctors, I’m doing physiotherapy and other things. Now I can see, like I’m able to spend time with my kids [and] family,” shared Mittal.
Mittal waited just two weeks for his transplant. The “heart in a box” technology is expected to lower wait times for others on the transplant list by better preserving organs and extending potential transport time up to 12 hours.
“We unfortunately have people waiting for transplants who become too sick for a transplant or even die on a transplant waitlist. We expect this is going to increase donor heart availability by upwards of 40 percent,” explained Nagpal.
This procedure resulted from years of collaboration among LHSC, Ontario Health, and Trillium Gift of Life Network in London.
Raj Mittal (left), the recipent of the first heart-in-a-box transplant with Cardiac Surgeon, Dr. Dave Nagpal. HANDOUT/London Health Sciences Centre Keep it Factual
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