Successful heart transplants in two children. Great success of the Medical University of Warsaw

A breakthrough event at the Medical University of Warsaw. Cardiac surgeons there performed the first two heart transplants in this center, both in teenage patients. So far, the Medical University of Warsaw has performed mainly kidney, liver and pancreas transplants, as well as bone marrow transplants.

1. A few weeks ago, at the Medical University of Warsaw, a 16-year-old boy with dilated cardiomyopathy underwent a heart transplant
2. The second heart transplant was performed by local cardiac surgeons in a 16-year-old patient, also with a congenital heart defect, which was caused by atresia (atresia) of the tricuspid valve
3. A third, this time a 15-year-old patient with the so-called Epstein’s syndrome
4. You can find more such topics on the TvoiLokony home page

Two life-saving transplants

The organ transplant program is being expanded at the Medical University of Warsaw. In the last few weeks, two urgent, life-saving heart transplants have been performed on teenage patients with congenital heart disease. These were the first two transplants of this organ at this center. Another teenage patient is waiting for a similar transplant.

According to PAP, the head of the Department of Cardiac Surgery of the Medical University of Warsaw, Prof. Mariusz Kuśmierczyk, the first heart transplant a few weeks ago was performed at the Medical University of Warsaw in a 16-year-old boy with dilated cardiomyopathy. It is a congenital heart defect that causes the heart cavity to widen as a result of stretching of the heart muscle with fibers, leading to heart failure.

– Before the boy was brought to us, no one in the family knew before that the boy had heart failure, not even he himself was aware of it. His condition deteriorated sharply when he fell ill from a respiratory infection. He came to us, to the Medical University of Warsaw in a very bad condition – said the specialist.

The patient was initially treated with drugs, incl. catecholamines, and his condition began to improve. The idea was for it to last for a heart transplant. – Fortunately, soon, after a few days, the donor was found and we performed the transplant – explained Prof. Mariusz Kuśmierczyk, former president of the Polish Society of Cardio- and Thoracic Surgeons.

They got new hearts

He noted that an adult heart can be implanted in a teenager, especially in a patient with dilated cardiomyopathy, when the heart is significantly dilated and the heart cavity is larger. It is worse with restrictive or hypertrophic cardiomyopathy when the heart muscle is small and there is little room for implanting a new, healthy heart from an adult donor. – The discrepancy in the body weight of the donor and the recipient may reach 30%, i.e. the recipient may weigh, for example, 50 kg, and the donor – 70 kg – he added.

The second heart transplant was performed by the cardiac surgeons of the Medical University of Warsaw in a 16-year-old patient, also with a congenital heart defect, which was caused by atresia (atresia) of the tricuspid valve. Its course was even more dramatic. The result of this defect is the so-called single-chamber heart, where one chamber of the heart is residual or severely underdeveloped and cannot be corrected (so that the heart is functionally biventricular).

This disorder is caused, among others, by underdevelopment of the left ventricle, atresia of the tricuspid valve, or atresia of a pulmonary valve. It is then necessary to perform an operation using the Fontan method, and in the case of the underdevelopment of the left heart – the Norwood method. The latter is carried out in three stages, the final result of which is a single-chamber heart that functionally replaces the normal two-chamber heart.

Prof. Mariusz Kuśmierczyk explains that after such surgery, the patient develops blood stagnation after some time, especially in the abdominal cavity. And as a result of passive hyperemia, cirrhosis of the liver and primary liver cancer can develop. – Such patients need a heart and liver transplant – he emphasizes.

So far, everything is fine

A 16-year-old boy with a single chamber heart, treated at the Medical University of Warsaw, developed aortic valve insufficiency. – When blood flows from the left ventricle to the whole body, it should close, then the heart ventricle fills again and this cycle repeats. The regurgitation of this valve in this patient damaged his ventricle and caused it to stretch, the specialist told PAP.

This valve had to be replaced with an artificial one and the aortic aneurysm (more than 5 cm in diameter) that had arisen above this valve had to be removed. – In this way, we wanted to postpone the necessity to perform a heart transplant. Unfortunately, the patient’s ventricle did not endure. It was necessary to immediately connect it to the ECMO (apparatus for oxygenating the blood, used in patients with circulatory failure – PAP). It was necessary to search for a donor urgently, because a heart transplant in this patient was already necessary – he argued.

However, ECMO while waiting for a donor, the heart was insufficient (due to vascular complications). – In this situation, we imported artificial heart chambers from Berlin (the so-called Berlin Heart). In the meantime, however, a heart giver was found for this boy. Here, however, another problem appeared, because it turned out that the heart of a potential donor was not suitable for transplantation. Therefore, we implanted the patient with the supplied Berlin Heart chambers – he recalled in an interview with PAP.

The boy’s condition then began to improve, which is more difficult in the case of a single-chamber heart. A donor was found, there was finally a chance for a heart transplant, the cardiac surgeons of the Medical University of Warsaw decided to use it and perform a transplant. – It was a huge risk transplant, but so far everything is fine – assures prof. Mariusz Kuśmierczyk.

A third, this time a 15-year-old patient with the so-called Epstein’s syndrome. This is a birth defect that causes the tricuspid valve to be abnormal. In his case, both the right and the left ventricles are abnormal. The boy is waiting for a donor.

Author: Zbigniew Wojtasiński