It's only about the size of a 50-cent piece, but a pacemaker is a lifesaver. This implantable medical device helps regulate the heartbeat. When a person dies with a pacemaker, the device often will have many more years of life left.
It makes sense, then, that pacemakers could be donated to someone who could benefit from it. But the Food and Drug Administration (FDA), which oversees U.S. medical devices, doesn't allow heart devices to be recycled, reports the American Heart Association (AHA). The FDA has labeled them for "single use" only, citing concerns about safety and sterilization for reuse.
But as the AHA points out, millions of sick people in low-income countries die every year because they can't afford a pacemaker. A pacemaker typically costs between $2,500 and $3,000, with wire leads to connect the device priced from $800 to $1,000. Many people could be saved if they could reuse the pacemakers that are removed each year from Americans who receive upgraded devices or who die with their pacemakers still functioning.
According to a 2017 pacemaker recycling feasibility study published in the World Journal of Cardiology, more than 90 percent of people with pacemakers said they would donated their devices to people in need if they could.
How to donate
Since the FDA doesn't allow pacemaker reuse in the U.S., nonprofit groups work to get the devices cleaned and sent out of the country.
My Heart Your Heart is a program at the University of Michigan that collects used pacemakers and implantable cardiac defibrillators (ICD), which typically act as pacemakers but also detect abnormal heart rates. The organization collects the devices from patients and funeral directors, sterilizes them, and then sends them abroad to foreign countries.
"We're essentially providing therapy that basically would not be available to these countries at all. That is really what we're all about," Dr. Thomas Crawford, a cardiologist and director and principal investigator for My Heart Your Heart, told the AHA.
Other groups donate brand new pacemakers to people in need around the world. Heartbeat International receives donated devices from medical manufacturers, then recruits volunteer cardiologists and physicians in foreign countries to implant them and provide follow-up care.
Pacemakers don't have to go overseas to give a second chance at life. Some veterinary schools will implant the devices into four-legged recipients.
Schools like the University of Georgia's College of Veterinary Medicine will occasionally receive donated devices and perform a procedure to place them in dogs or cats.
Veterinary cardiologist Dr. Clay Calvert, told ABC News that 3,000 to 4,000 dogs in the U.S. need a pacemaker every year. But only one out of 10 dogs gets the device because the surgery is often so cost-prohibitive.
"The potential of pacemakers" in dogs, he says, "is every bit as promising as it is in humans."
Veterinarians at the University of Tennessee College of Veterinary Medicine perform the procedure on pets with pacemakers that come from several sources. Some are donated by family members; others come from hospitals or manufacturers when the devices are near the end of their shelf life, reports the Knoxville News-Sentinel.
The Companion Animal Pacemaker Repository is a clearinghouse where manufacturers can donate their devices so veterinary cardiologists can find them and order them online.
Guiedo, a 12-year-old hound mix, received one of these donated pacemakers after being diagnosed with an abnormal heart rhythm known as heart block.
"It didn't even enter my mind not to do the surgery," Maxine Mager, founder of Creative Acres Animal Sanctuary in Brighton, Colorado, told HealthDay. Even with the lower-priced device, the surgery cost $5,000, which didn't deter Mager.
"What an amazing thing to do with the money — to give life."