Raj Mittal’s new heart came in an unusual package.
asserted
heart → come → package
After a cardiac arrest and a triple bypass in June, 2025, he spent a month and a half sedated in intensive care at the London Health Sciences Centre in Ontario before he could return home to his wife and two children.
uncertain
he → spend → wife
When his heart condition led to pneumonia in January and another hospital stay, he learned he was a candidate for a heart transplant.
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he → lead → transplant
Typically heart donors are patients who have been declared brain dead, but whose hearts are still beating.
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hearts → declare → ?
Once the organs are removed they are placed on ice, and can last in this state for only up to six hours, limiting how far they can travel.
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they → remove → hours
But when Mr. Mittal’s heart arrived in February, two weeks after he was added to Ontario’s transplant list, it was still warm and pumping blood.
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it → arrive → blood
According to the London hospital, which performed the transplant, he was the first Canadian to receive what is is colloquially called a “heart in a box.”
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what → accord → box
The box, which is actually a cart-sized medical device on wheels with a chamber where the organ can rest and receive blood through a system of tubes, doubles a donor heart’s potential lifespan to 12 hours.
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organ → rest → hours
With the longer timeframe, a heart can travel much farther than was previously possible.
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heart → travel → timeframe
The box can also revive hearts after they stop beating, expanding the pool of donors to include patients who die after circulation stops.
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circulation → revive → patients
In ordinary circumstances, these organs wouldn’t be considered viable.
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organs → consider → circumstances
“It’s a second life for me,” said Mr. Mittal, a 50-year-old information technology professional.
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Mittal → ’ → me
Dave Nagpal, medical co-director of the multiorgan transplant program at the London Health Sciences Centre and its director of cardiac transplantation, called the technology “fascinating.”
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Nagpal → call → technology
The box, formally known as an Organ Care System, is made by TransMedics, a company headquartered in Massachusetts.
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box → know → Massachusetts
Once a donor heart is removed, Dr. Nagpal said, the device can be attached to the organ, which starts pumping again.
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which → remove → organ
“You can hook the heart up to this device and actually watch it regain function and assess the function of the heart based on the visual appearance, but also based on the laboratory investigations that we can do on the device,” Dr. Nagpal said.
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Nagpal → hook → device
“This additional technology allows us to get more donor hearts into those recipients that really need them.”
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that → allow → them
He acknowledges it took a village for the technology to be made available in Ontario.
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technology → acknowledge → Ontario
Hearts from Canadian donors have previously been revived in the devices, but they were transplanted into American recipients.
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they → revive → recipients
Ontario Health, a provincial agency, financed the equipment.
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Health → finance → equipment
The acquisition took years of collaboration with the Trillium Gift of Life Network, an agency responsible for delivering and co-ordinating organ and tissue donation and transplantation services across the province.
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acquisition → take → province
And the physicians who would use the device required special training.
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who → use → training
Before Mr. Mittal’s transplant, the hospital’s cardiac surgeon, Rashmi Nedadur, had to retrieve the donor’s heart from another location that the hospital says it cannot disclose.
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it → have → that
Dr. Nedadur assessed how the heart was functioning and deemed it viable for transplant.
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it → assess → transplant
He brought it back to the London hospital, where a surgical team was prepped and ready to scrub in.
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team → bring → hospital
In the operating room, major vessels were trimmed to fit Mr. Mittal’s anatomy.
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vessels → trim → anatomy
The heart also needed to be protected through a process that involved special solutions and temperature control.
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that → need → solutions
Once the heart was sewn into Mr. Mittal’s chest, Dr. Nedadur said, the heart “took off immediately.”
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heart → sew → chest
Just days after the transplant procedure Mr. Mittal started feeling more like himself.
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Mittal → start → himself
He could get up and move in the intensive care unit, before he was transferred to the hospital’s transplant unit.
uncertain
he → get → unit
He had to return briefly to the ICU to manage his blood pressure and fluid levels.
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He → have → pressure
But later that month he was able to go home.
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he → go → ?
These days, Mr. Mittal is recovering well.
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Mittal → recover → ?
But he said he has to remind himself to go slow.
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he → say → himself
He is doing cardiac rehabilitation and takes medication daily.
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He → do → medication
Although he remains on leave from his job, he is finding joy in simple things, such as being able to get outside for walks.
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he → remain → walks
This is a marked improvement from life before the transplant, he said, when his energy levels were so low he couldn’t enjoy time with family.
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he → say → family
He hopes that with more time, his new heart will eventually allow him to get back to doing more.
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him → hop → more
His main goals are to return to work, and, by next summer, get back on his bike.
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goals → return → bike
He enjoys riding alongside his children, now 11 and 17.
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He → rid → children
…and 2 more, not listed.
The Aporia
