Heart surgery requiring the heart-lung machine (cardiopulmonary bypass) saves lives but can cause brain and kidney problems in many patients. Now, researchers from The Florey have teamed up with clinical specialists at hospitals across Victoria and South Australia as part of the MEGA-HEART project, which tests a Florey-patented treatment with the goal of reducing brain and kidney injuries.
“Many people wake from life-saving heart surgery in a confused, forgetful and disturbed state. And many experience minor to severe kidney problems,” Lead investigator Professor Yugeesh Lankadeva said — noting that up to half of all heart surgery patients experience postoperative delirium and 30% of patients have acute kidney injury. “These issues can lengthen or complicate recovery or may even prove fatal in some cases — yet no therapies are available.”
The project centres on administering a “mega-dose” of a novel formulation of sodium ascorbate, which was recently developed and patented by The Florey to treat heart surgery patients in operating theatres and intensive care units. Following three years of developing methods for studying the effects of heart surgery and cardiopulmonary bypass on brain and kidney health in sheep, Lankadeva said the preliminary data was “compelling” and “suggests our formulation of sodium ascorbate reduces neuroinflammation, which may prevent delirium. It also appears to reduce kidney inflammation, hypoxia and cell death in the inner region of the kidney — the renal medulla — which may prevent acute kidney injury”.
$4.9 million in support for the research over five years from the Australian Government’s Medical Research Future Fund will enable the project to: identify the optimal dose of sodium ascorbate to reduce or prevent inflammation in the brain and prevent inflammation, hypoxia and cell death in the kidneys in sheep; determine immunological and physiological mechanisms by which a mega-dose of sodium ascorbate exerts its effects of vital benefit to organs; and establish efficacy and safety of the sodium ascorbate optimal dose in patients undergoing heart surgery in hospital-based trials.
“We aim to follow this project with larger-scale clinical trials to transform the management of patients undergoing heart surgery to improve brain and kidney health outcomes,” Lankadeva said. “Developing a therapy that prevents these common complications could be the biggest development in peri-operative heart surgical care in the last 25 years. It’s a tremendously exciting time to be working in this space, and a privilege to be able to help move this therapy from the bench to the bedside.”
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Patients will be recruited for the clinical trial, which will also involve peri-operative and critical care physicians from The Alfred, Austin Health, The Victorian Heart Hospital, Royal Adelaide Hospital and The Royal Melbourne Hospital.
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