Last year we broke the Polish record in the number of heart transplants – says cardiac surgeon Michał Zembala

– The number of 83 heart transplants we have performed at our Center is one of the better, if not the best results in Europe in 2020 – says Dr. Michał Zembala, Coordinator of the Department of Cardiac Surgery, Heart and Lung Transplantation and Mechanical Circulation Support at the Silesian Center for Heart Diseases in Zabrze. On January 26, we celebrate the National Transplant Day

1. Last year, 83 heart transplants took place at the Silesian Center for Heart Diseases in Zabrze – this is a record result of this facility, all the more deserving of recognition, taking into account the circumstances of the pandemic
2. According to Dr.Michał Zembala, this result is the result of the growing awareness in our society about donation, as well as the effective activities of organizations related to transplantation and a greater number of organs donated by hospitals
3. Several coronavirus-damaged lung transplant surgeries were also carried out in the Zabrze center
4. You can find more such topics on the TvoiLokony home page

Adrian Dąbek, Medonet: Apparently, last year was record-breaking. How many transplants did you have in 2020?

Dr.Michał Zembala: At the Silesian Center for Heart Diseases in Zabrze, we have performed nearly 1600 surgical procedures, including 83 heart transplants – a very good result, taking into account the time in which we have to function. 83 transplants is a new Polish record, the result is much better than the one achieved in 2018, then there were 74 procedures, in the next one it was slightly less.

You also transplanted the lungs of a patient infected with the coronavirus.

Not one. Lung transplantation procedures in patients in whom COVID-19 caused massive damage were performed by the team of Dr. Urlik and Assoc. Ochman. Working with intensive care units in Zabrze, headed by prof. Knapik, doc Trejnowska and the team of Dr. Serednicki from Krakow, colleagues rescued patients whose lungs practically did not function – they breathed thanks to ECMO – extracorporeal oxygenation system. As far as I know, the patients are functioning very well. The team’s success is very big.

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And were there also cases where the heart transplant was caused by the coronavirus?

In 2020, we had several cases of patients whose qualification for transplantation was due to acute complications of a heart attack. They were not victims of a dangerous virus, but rather an example of how much the pandemic changed the treatment of patients with acute coronary syndrome. Before the pandemic, a patient with a heart attack was treated quickly and efficiently with percutaneous coronary angioplasty (stent). During COVID, when the availability of this type of care and treatment was limited – due to fear, ambulance delays or lack of places in hospitals – we observed many complications of myocardial infarction, such as a broken heart wall, ventricular aneurysm or massive damage to the ventricle – conditions that have not been observed in Poland for a long time .

Is the transplant procedure in a patient with COVID-19 different to a transplant without the virus?

As it turned out, many of our patients have had COVID-19. I would say it was 10-15 percent. of all the patients we have transplanted, and now it’s about 20 percent. the patients we operate on. These are people who underwent SARS-COV-2 infection, more or less symptomatically, in the past year. Will it affect long-term survival after transplantation? We do not know this yet, but we are researching it meticulously. We look at and follow the fate of transplant patients who receive coronavirus vaccinations today.

What made last year so record-breaking?

The number of 83 heart transplants is one of the better, if not the best results in Europe in 2020. It is not so much the team’s success as the system’s success. For the last two years, significantly more donors have been reported. We can see a very high activity of smaller, municipal and poviat centers and hospitals, which so far reported little, and now, thanks to new people, mainly young medics, they are becoming more active.

A good example is Zakopane, which has not reported any donors for over 15 years – now, thanks to a talented anaesthesiologist, it has started an ambitious donation program. It is only a matter of people, their attitudes, their beliefs and the belief that they can help many who are waiting. The role of Poltransplantu, as well as other organizations and social initiatives, such as Run for New Life or the “Tak dla transplantacji” foundation, is also important – they effectively promote the idea of ​​transplantation, donation and “sharing” after death.

1. He was an unbeliever, but they called him Saint – prof. Zbigniew Religa repaired thousands of Polish hearts

The attitude of society is also different than 5-10 years ago. We have a different awareness, we also have a different generation that thinks differently, has different perceptions and expectations. The young generation is growing up on Facebook or Instagram and sees how much good the gift of life, which is organ transplantation, brings. The teaching of “giving” is also included in the concept of “The Organs” stuffed animals – pillows in the shape of a heart, lung or liver, which teach children that the heart can be, for example, given away.

Why are there still many people who do not consent to organ donation? What are they afraid of?

In the case of disagreement, the will of the deceased is mainly emphasized, without giving a reason. We do not penetrate, analyze or judge. The will of the deceased, expressed in the words of the family, is unquestionable.

What are the most common causes of heart transplants?

Circulatory failure caused by atherosclerosis, or ischemia, is still dominant – ischemic or post-infarction cardiomyopathy accounts for nearly 50 percent. indications for transplant. Another group is post-inflammatory cardiomyopathy, i.e. cardiomyopathy caused by inflammation of the heart muscle, very often post-influenza-related. There is also a third group, namely congenital defects and a group of patients with hypertrophic cardiomyopathy.

What does heart-related prophylaxis look like? We take care of them properly, is there still much to be done in this topic?

Preventive cardiology begins to find its rightful place in our consciousness – meetings and symposia conducted last year by prominent cardiologists – prof. Witkowski, prof. Jankowski or prof. Hryniewiecki will surely bring a harvest. Educating the public is extremely important, but its effects will only be visible in the long run.

1. Read the second part of the conversation with Dr. Michał Zembala HERE

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