The OCS Heart device is currently the only equipment in the world used to transport a “still beating” heart harvested for transplantation. The solutions used make it possible to extend the useful life of the organ for implantation almost three times – from 4 to 12 hours. Currently, in Poland, the heart after collection is transported in ice and is fit for transplantation only for 4 hours. After exceeding this time, counted from collection to implantation, it is not known how the transplanted heart will behave.
“Heart transplantation is the only chance to live for many people in our country,” emphasized Prof. Zbigniew Gaciong, Rector of the Medical University of Warsaw. “As a university, we are extremely proud that the organ transplantation program, which historically began in Warsaw (at the Medical Academy, in 1966), is still developing. Moreover, it has been extended to include heart and lung transplantation, also the most difficult pediatric cases. The Medical University of Warsaw is also a place where doctors and others can train in the specialties that are necessary for organ transplantation.”
Pioneering Transplantation – March 4, 2024
Using an innovative system, a heart was transplanted into Mr. Jerzy, who had been in a serious condition for over 7 weeks at the Central Clinical Hospital of the University Clinical Center of the Medical University of Warsaw at Banacha Street. After it was collected from the donor, the heart was outside the human body for about 7 hours. A team of experts led by cardiac surgeon and clinical transplantologist Prof. Mariusz Kuśmierczyk made sure the “heart in the box” (placedin the OCS Heart device) was safe. Key members of the team carrying out this very complex procedure were trained in Hannover. The compliance of handling the equipment was monitored in every step of the way by Cynthia Aucella from TransMedics. After 7 hours of being kept in the “box”, the heart was implanted in the recipient.
“The system worked and the performance of our team was flawless. This is how Polish heart transplantology has emerged from the ‘ice age’. We have entered a new era of heart transplantation in our country,” said cardiac surgeon and clinical transplantologist Dr. Zygmunt Kaliciński.
It has now been a month since the procedure. How is the patient feeling?
“I am recovering very quickly. It is getting better every day,” said Mr. Jerzy. “My test results are also good. I just got a new life and now I’m going to enjoy it and make the most of it.”
How is the OCS Heart system changing Polish transplantology?
OCS Heart is a portable, warm perfusion and monitoring system designed to maintain a donor’s heart in a metabolically active state, in conditions very similar to those in the body. By monitoring key parameters of the living heart doctors can assess the potential health and viability of the organ. Nowadays, the continuous heart perfusion system allows to increase the number of transplants performed without deterioration of the results of this method, improve treatment results and reduce the cost of patient care.
“The use of this innovative equipment by my team enables heart transplantation in currently excluded patients, for example those with congenital heart defects who underwent many palliative surgeries in childhood. These are young adults, around 18-30 years old, whose hearts, which have been operated on many times, end their life. Transplantation in these patients takes more than 4 hours in each instance. The use of the OCS Heart system significantly improves the results in high-risk groups, for example in recipients on artificial ventricular support, and the results of repeat transplants. Thanks to this system, we can achieve better results in standard transplants, because the patient’s stay in the Intensive Care Unit is shorter and there is less rejection of the transplanted organ. A better selection of donors in terms of tissue and human leukocyte antigen compatibility is also possible,” said Prof. Mariusz Kuśmierczyk.
Prof. Mariusz Kuśmierczyk emphasized that the possibility of using the system increases the pool of suboptimal donors, for example older ones or those with borderline functional hearts, because this allows transplantologists to evaluate the heart and make an appropriate decision about implantation or abandonment, and it also expands the donor pool to include people who were declared dead on the spot or after unsuccessful resuscitation. Implantation can take place even after a 30-minute cardiac arrest, provided that the heart is revived and nourished in the OCS system. The evaluation of function is important here. The use of OCS Heart also gives specialists a long, 12-hour, time margin, which allows them to increase transport flexibility to reach distant hospitals and transport the heart over long distances. Moreover, this system improves quality of transplant services by shortening the waiting time for transplantation for patients with end-stage heart failure. This reduces the incidence of serious complications and shortens the average hospitalization time, which is important in reducing the cost of postoperative care.
The history of acquiring innovative equipment for the Medical University of Warsaw
About 5 years ago, cardiac surgeons Prof. Mariusz Kuśmierczyk and Dr. Zygmunt Kaliciński faced the problem of heart transplantation in patients who had been operated on many times in their youth due to congenital heart defects, most often single-ventricular heart, for whom the only chance to save their lives is to transplant this organ.
Unfortunately, this type of transplantation requires a lot of preparation and during the operation it is necessary to reconstruct the right anatomy when implanting a new, normal heart in place of the single-ventricular one. This transplant requires more time than a regular transplant. Wanting to save their patients, Prof. Mariusz Kuśmierczyk and Dr. Zygmunt Kaliciński were looking for a solution to the encountered limitations and learned about American equipment that allows the heart transport time to be extended threefold, up to 12 hours. The equipment has already been successfully used in many European countries. That was the solution the doctors were looking for.
Unfortunately, the system turned out to be extremely expensive. Therefore, a fund-raising campaign titled “12 Hours for Life” was launched under the aegis of the existing Foundation for Transplantation “Leave your heart on Earth” headed by Dr. Zygmunt Kaliciński. The Foundation promoted the idea of transplantation and conscious donation by organizing concerts (including performances of the “HLA4transplant” band, in which Dr. Zygmunt Kaliciński plays drums), among others. The fundraising for the purchase of OCS Heart started despite adversities such as Covid and the war in Ukraine. Thanks to the involvement of doctors, artists and donors, the equipment was purchased in December 2023 and given as a donation from the Foundation for Transplantation to the University Clinical Center of the Medical University of Warsaw. Thanks to all that the “heart from the box” was transplanted a month ago, on March 4, 2024, with great success at the Medical University of Warsaw Medical University,for the first time in Poland.
Members of team of the Clinic of Heart, Thorax and Transplant Surgery who participated in the first in Poland transplant of the “beating Heart in a Box” using the OCS
Heart system:
- chief surgeon: Prof. Mariusz Kuśmierczyk – cardiac surgeon, clinical transplantologist, Head of the Clinic of Heart, Thorax and Transplant Surgery
- first assistant: Dr. Marek Bartkowiak – cardiac surgeon
- second assistant: Dr. Zbigniew Popiel
- instrument nurses: Natalia Dorobek, Lidia Pastwa
- anesthesiologist: Dr. Tadeusz Bering,
- anesthesiology nurse: Agata Dębek
- perfusion (heart-lung): Edyta Sulkowska.
OCS Heart Team – “Heart in a Box”:
- Dr. Zygmunt Kaliciński – cardiac surgeon, transplantologist, coordinator
- Karolina Żbikowska – cardiothoracic surgery resident, coordinator
- Mateusz Wondołowski – cardiac surgery resident, coordinator
- Zuzanna Strzka-Kliś – specialist in mechanical heart support devices, coordinator
- Jakub Koscielek – specialist in mechanical devices supporting the heart, coordinator
On Friday, March 5, 2024, a press conference was held with the participation of:
- Mr. Jerzy – the patient who had a heart implanted a month ago during the first transplantation in Poland using the organ care system (OCS)
- Prof. Zbigniew Gaciong, Rector of the Medical University of Warsaw
- Prof. Mariusz Kuśmierczyk, cardiac surgeon, clinical transplantologist, Head of the Clinic of Heart, Thorax and Transplant Surgery, The University Clinical Center of the Medical University of Warsaw
- Dr. Zygmunt Kaliciński, cardiac surgeon, clinical transplantologist, founder of the Foundation for Transplantation
- Anna Łukasik, Director of the University Clinical Center of the Medical University of Warsaw.
The conference was led by Marta Wojtach, Communication Director of the Medical University of Warsaw.
