Heart transplantation in Ukraine: experience of one center
Article Sidebar
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Main Article Content
https://orcid.org/0009-0000-2047-4447
Abstract
The aim – to show and analyze our own experience of performing orthotopic heart transplantation in patients with end-stage chronic heart failure.
Materials and methods. The work retrospectively analyzed the results of 106 cases of orthotopic heart transplantation in adults and children, which were performed by the heart transplantation team of the Heart Institute of the Ministry of Health of Ukraine during 2019–2024.
Results. Standard donor hearts were received by 67 (63.3 %) recipients. Marginal donor hearts were used in 39 (36.7 %) cases. In 97 (91.5 %) cases, patients underwent isolated orthotopic heart transplantation. In other cases, coronary artery bypass grafting was performed in 4 (3.75 %) cases, correction of valvular pathology of the donor heart – in 4 (3.75 %) cases, and correction for congenital heart disease – in 1 case. The median duration of ischemia time of the donor heart was 80 (70; 95) minutes. Among the postoperative complications, the most common was a primary graft dysfunction – in 11 (10.4 %) cases. There was no statistical difference in the frequency of postoperative complications between patients with marginal or standard donor hearts. One-year and two-year survival according to Kaplan–Meier was 88.4 ± 4.5 % (95 % CI 81.9–95.5 %) and 86.7 ± 5.7 % (95 % CI 75.9–94.5 %).
Conclusions. Our first experience with heart transplantations showed encouraging immediate and medium-term results. Due to the use of marginal donor hearts, we were able to increase the donor organ pool by 40 %. Follow-up is ongoing.
Article Details
Keywords:
References
Zhu Y, Lingala B, Baiocchi M, Arana V, Williams K, Shudo Y, et al. The Stanford experience of heart transplantation over five decades. Eur Heart J. 2021;42:4934–43. https://doi.org/10.1093/eurheartj/ehab416. DOI: https://doi.org/10.1093/eurheartj/ehab416
Kim JC, Youn JC, Lee SE, Jung SH, Kim JJ. Donor heart utilization in Korea. Int J Heart Fail. 2020;2:254–63. https://doi.org/10.5455/ijhf.2020.254-63. DOI: https://doi.org/10.36628/ijhf.2020.0011
Shah K, Kittleson M, Kobashigawa J. Updates on heart transplantation. Curr Heart Fail Rep. 2019 Oct;16(5):150–6. https://doi.org/10.1007/s11897-019-00432-3. DOI: https://doi.org/10.1007/s11897-019-00432-3
Database UNOS.
Kovtun G, Shpachuk A, Chaikovska S, Sudakevych S, Todurov B. Organization of transplantation assistance through transportation of the recipient to the regional explantation base for heart transplantation. East Ukr Med J. 2024;12(2). https://doi.org/10.21272/eumj.2024;12(2). DOI: https://doi.org/10.21272/eumj.2024;12(2):390-397
Todurov B, Kovtun G, Chaikovska S, Sudakevych S, Kaniura O. Orthotopic heart transplantation in a persistent left superior vena cava: case report. Clin Prev Med. 2024;4(34):88–93. https://doi.org/10.31612/2616-4868.4.2024.12. DOI: https://doi.org/10.31612/2616-4868.4.2024.12
Zaroff JG, Rosengard BR, Armstrong WF, et al. Consensus conference report: maximizing use of organs recovered from the cadaver donor: cardiac recommendations, March 28–29, 2001, Crystal City, Va. Circulation. 2002;106:836–41. https://doi.org/10.1161/01.cir.0000026614.51603.b5. DOI: https://doi.org/10.1161/01.CIR.0000025587.40373.75
Lee SY, Kim SH, Ju MH, Lim MH, Lee CH, Je HG, et al. The clinical outcomes of marginal donor hearts: a single center experience. Korean Circ J. 2023 Apr;53(4):254–67. https://doi.org/10.4070/kcj.2022.0197. DOI: https://doi.org/10.4070/kcj.2022.0197
Awad MA, Shah A, Griffith BP. Current status and outcomes in heart transplantation: a narrative review. Rev Cardiovasc Med. 2022 Jan 11;23(1):11. https://doi.org/10.31083/j.rcm2301011. DOI: https://doi.org/10.31083/j.rcm2301011
Hwang NC, Sivathasan C. Review of postoperative care for heart transplant recipients. J Cardiothorac Vasc Anesth. 2023 Jan;37(1):112–26. https://doi.org/10.1053/j.jvca.2022.09.083. DOI: https://doi.org/10.1053/j.jvca.2022.09.083
Mahmood F, Topol EJ. Digitising heart transplant rejection. Lancet. 2022 Jul 2;400(10345):17. https://doi.org/10.1016/S0140-6736(22)01204-1. DOI: https://doi.org/10.1016/S0140-6736(22)01204-1
Sathianathan S, Bhat G. Heart transplant donor selection guidelines: review and recommendations. Curr Cardiol Rep. 2022 Feb;24(2):119–30. https://doi.org/10.1007/s11886-021-01631-y. DOI: https://doi.org/10.1007/s11886-021-01631-y
Zakon Ukrainy 2427-VIII vid 07.01.2022 «Pro zastosuvannia transplantatsii anatomichnykh materialiv liudyni» [Internet]. Available from: [https://zakon.rada.gov.ua/laws/show/2427-19/conv#Text](https://zakon.rada.gov.ua/laws/show/2427-19/conv#Text).
Wittwer T, Wahlers T. Marginal donor grafts in heart transplantation: lessons learned from 25 years of experience. Transpl Int. 2008 Feb;21(2):113–25. https://doi.org/10.1111/j.1432-2277.2007.00603.x. DOI: https://doi.org/10.1111/j.1432-2277.2007.00603.x
Park JJ. To Take or Not to Take: The Dilemma With Marginal Donor Heart? Korean Circ J. 2023 Apr;53(4):268–70. https://doi.org/10.4070/kcj.2023.0045. DOI: https://doi.org/10.4070/kcj.2023.0045
Bifulco O, Bottio T, Caraffa R, et al. Marginal versus standard donors in heart transplantation: proper selection means heart transplant benefit. J Clin Med. 2022;11:2665. https://doi.org/10.3390/jcm11092665. DOI: https://doi.org/10.3390/jcm11092665
Galeone A, Lebreton G, Coutance G, et al. A single-center long-term experience with marginal donor utilization for heart transplantation. Clin Transplant. 2020;34:e14057. https://doi.org/10.1111/ctr.14057. DOI: https://doi.org/10.1111/ctr.14057
Woods JR, Saywell RM Jr, Nyhuis AW, Jay SJ, Lohrman RG, Halbrook HG. The learning curve and the cost of heart transplantation. Health Serv Res. 1992 Jun;27(2):219–38.