The slogan of today, tomorrow and always is: leave the hearts on Earth. Without them, no patients can be saved.

prof. Zbigniew Gaciong

On December 3rd 1967 in Cape Town, professor Christian Barnard performed a successful heart transplant surgery on a patient who was terminally ill with heart failure as the first one in the world [1]. Unfortunately, due to the turbulent health history of the recipient, a 54-year-old man suffering from diabetes, 3 heart strokes and extreme heart failure, he lived only 18 days after the surgery. A year later, Bernard unleashed his strengths again while performing the second in his career heart transplant surgery. This time patient lived 19 months with his new heart after the procedure [1]! These first surgeries were famous worldwide and started a very crucial era in the surgery field – an era of heart transplants.

In 2021 according to the data from Poltransplant, 200 heart transplants took place in Poland which is a record for now [2]. Undoubtedly, transplantology in Poland is developing in the right direction including paediatric transplantology. 

Milestone

Clinical centres of Warsaw Medical University (WUM) have been considered the best centres for transplantation in Poland for a long time. Currently, in these hospitals, transplants of livers, kidneys, pancreas, retinas, lungs, hearts and multi-organ transplants are taking place [3]. In August 2022 another milestone for WUM’s transplantology happened. That is when specialists from University’s Clinical Centre (UCK) performed their first heart transplants – both in pediatric patients – 16-year-old boys!

The first patient got into the hospital on the 29th of July with extensive heart failure – dilated cardiomyopathy. The condition, that the boy was suffering from, has been developing imperceptibly for a couple of years which is why such a diagnosis was a huge surprise to both himself and his family [4]. The whole process of transplant eligibility and recruitment of a donor was instant. The heart was transported via police helicopter and thanks to that, specialists from UCK WUM received it in less than 1.5 hours [4]. It is vital as the maximum cold ischemia time for the heart is 4 hours and after that time the risks of failure of a procedure significantly increase [4]. 

A couple of days later, on the 19th of August, specialists from UCK WUM performed another heart transplant and the recipient was another 16-year-old patient [4]. In this case, the boy was waiting for a heart transplant for almost all of his life as he was suffering from a congenital heart defect – tricuspid artesia, which means that the valve between the right heart chambers is not formed and the heart is undeveloped [4]. This transplant was much more complicated than the previous one, as transplants on patients with single-chambered hearts are very rare both in Poland and worldwide. Fortunately, the procedure was successful and the prognosis for both patients is great [4]. 

At the end of 2022, specialists from UCK WUM conducted another heart transplant in this case returning their 9-year-old patient – Lenka – her normal life again [5]. The girl was suffering from restrictive cardiomyopathy which is a disease when the heart is pumping blood in the wrong way. After successful transplantation, the little patient was feeling better straight away but she stayed under the supervision of physicians during the convalescent time. 

The program of organ transplant at UCK WUM

The two previously mentioned transplants was the beginning of a planned organ transplant program at UCK WUM [3]. It is important to mention that UCK WUM is the second centre in Poland where children heart transplantations are possible[4]. The organ transplant program at UCK WUM aims to deliver new opportunities for many patient groups and seeks to allow all the organs derived from one donor to be transplanted in one place (without the necessity of transportation) [3]. 

Based on the statistics, from January to August 2022 at UCK WUM there were 320 transplantations [4]! It included 103 kidney transplants from dead donors and 29 from alive donors, 141 liver transplants, 6 pancreas transplants, 36 bone marrow transplants and 5 heart transplants [4]. Importantly, out of 111 heart transplants performed in the whole country, 10 concerned pediatric patients out of which 2 were performed at UCK WUM [4]. Based on the example of 9-year-old Lenka we can notice that transplantologists from WUM do not rest on their laurels. On the contrary, they fight for a better tomorrow. 

Leave the hearts on Earth

Due to the COVID-19 pandemic, there are fewer registered donors in Poland now. At the same time, approximately 20-30% of patients who qualified for a transplant are dying because of the limited number of available organs [2]. During the press conference at the Pediatric Hospital WUM in August 2022 prof. Zbigniew Gaciong – WUM rector – asked the society and medical environment to promote the idea of organ donation: The slogan of today, tomorrow and always is: leave the hearts on Earth. Without them, no patients can be saved.

References: 

1.     Kobus G, Malyszko JS. The history of transplantation in the world and Poland. 2015 Jun 1;5(1):258. Available from: https://search.proquest.com/docview/1693681941

2.     News E. The record number of heart transplants in 2021 in Poland. [Internet]. 2022. (www.everethnews.pl). Available from: https://everethnews.pl/rekordowa-liczba-przeszczepow-serc-w-2021-roku-w-polsce/

3.     WUM. Transplantology at WUM [Internet]. (www.wum.edu.pl). Available from: https://www.wum.edu.pl/node/17362

4.     WUM. The first heart transplants at UCK WUM. [Internet]. 2022. (www.wum.edu.pl). Available from: https://www.wum.edu.pl/node/17293?fbclid=IwAR0agWPkuYmkpaAS5JG5QFCkrZDu6NRdXFnHjs2w-4wLa0Gxr7yt_sIQ-xI

5.  Jakub Kapiszewski. 9-year-old Lenka received a new heart. ‘I can be a normal child [Internet]. 24 Jan 2023. (www.onet.pl) Available from: https://wiadomosci.onet.pl/nauka/9-letnia-lenka-dostala-nowe-serce-bede-mogla-byc-normalnym-dzieckiem/m3fwwgb