Heart transplantations at the Heart Center IKEM, Prague, Czech Republic

Area of Science:

• Cardiology
• Transplantation Medicine
• Public Health Policy

Background:

• The Institute for Clinical and Experimental Medicine in Prague established its heart transplant program in 1984.
• Over 881 orthotopic cardiac transplantations were performed through November 2012.
• The program has adapted to challenges including increasing donor age and graft shortages.

Purpose of the Study:

• To provide an overview of the heart transplant program at the Institute for Clinical and Experimental Medicine in Prague.
• To describe current Czech Republic legislation on solid organ transplantation.
• To detail the program's evolving practices, including expanded donor selection and the integration of mechanical circulatory support.

Main Methods:

• Review of transplant program data from January 1984 to November 2012.
• Description of current immunosuppression protocols and induction therapy.
• Analysis of patient outcomes, including survival rates and common complications.

Main Results:

• An annual rate of approximately 40 heart transplantations has been maintained.
• Mechanical circulatory support, implemented in 2003, is now used in about half of transplant recipients.
• Non-ischemic heart failure is the primary indication, followed by ischemic cardiomyopathy, valvular lesions, and congenital heart disease.

Conclusions:

• The program has successfully adapted to changing donor demographics and graft availability.
• Mechanical circulatory support has become integral to managing chronic heart failure patients awaiting transplantation.
• Detailed insights into the program's protocols, outcomes, and management strategies are provided.