In a Canadian first, the cardiac team from London Health Sciences Centre (LHSC) has completed a heart transplant using the Transmedics Organ Care system, often referred to as “heart in a box.”The system allowed the team to implant a donor heart that may not have been eligible for a transplant otherwise. “Heart in a box” systems are used to revive a donor heart that has stopped beating after circulatory death, explained Dr. Dave Nagpal, co-director of the multi-organ transplant program.“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 the donor heart was Raj Mittal. He underwent a triple bypass surgery in 2025 and was readmitted in January of this year, where he was given the option of being placed on the organ donation list. He underwent transplant surgery in Feb. 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, and the “heart in a box” technology is expected to help reduce wait times for more on the transplant waitlist by better preserving organs and increasing potential transport time 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.The procedure was a result of years of collaboration between LHSC, Ontario Health, and Trillium Gift of Life Network in London.