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[Distant heart procurement in the Czech and Slovak Republics]
J Spatenka1, A Khaghani, M Yacoub
1Dĕtské transplantacní centrum FN Motol a 2. LF UK, Praha.
Summary
Distant heart procurement (DHP) enables heart transplantation (HTx) for end-stage heart failure patients when local donors are unavailable. Successful DHP over 1000 km demonstrates feasibility for establishing pediatric HTx programs.
Area of Science:
- Cardiovascular Surgery
- Transplantation Medicine
- Organ Procurement
Context:
- Heart transplantation (HTx) is a life-saving treatment for end-stage heart failure.
- Donor organ availability is a significant limitation in current HTx activity.
- Multiorgan harvesting and distant heart procurement (DHP) can expand donor pool.
Purpose:
- To evaluate the feasibility and outcomes of distant heart procurement (DHP) for pediatric heart transplantation.
- To assess the logistical and clinical challenges of organizing DHP for international organ transport.
- To determine if local expertise in DHP can support the establishment of a pediatric HTx program.
Summary:
- A Paediatric Transplant Center successfully performed 4 distant heart procurements (DHP) for heart transplantation (HTx) in the UK, transporting organs over 900-1100 km.
- Ischemic times ranged from 4:20 to 5:05 hours (mean 4:36), with transplants performed as both orthotopic and heterotopic procedures.
- Outcomes included successful long-term survival, graft failure due to rejection, and patient mortality, highlighting the complexities of DHP.
Impact:
- Demonstrates that a local transplant team can successfully organize and execute distant heart procurement (DHP).
- Provides evidence supporting the establishment of a dedicated pediatric heart transplantation (HTx) program.
- Highlights the critical role of coordination, communication, and transportation in successful DHP.