Sebastian Jost is 29 years old, and Sebastian Jost is alive. The latter cannot be taken for granted, as he received a donor heart for the second time at the end of May.
The first transplant had to be carried out when he was almost three years old. The reason: a severe disease of the heart muscle. 'I only have vague images and feelings in the back of my mind from back then - but no concrete memories,' says Sebastian Jost. This experience makes looking back on the past few weeks all the more vivid.
'After 26 years, the first donor heart was severely functionally impaired,' says Dr Katharina Seuthe, Senior Physician at the Clinic for Cardiology in the Heart Centre at Cologne University Hospital, where Sebastian Jost was initially treated. In addition to a recurring pericardial effusion, i.e., an accumulation of fluid in the pericardium surrounding the heart, the heart specialists diagnosed pathological changes in the coronary arteries, which meant that the heart was no longer sufficiently supplied with blood.
The Cologne heart team did everything they could to restore the heart's full function. However, it was repeatedly set back along the way, first due to a pulmonary embolism and then due to a cardiac arrest with immediate resuscitation. 'It was clear that my heart wasn't going to keep up,' Sebastian Jost realises matter-of-factly. The last resort: replacing the heart function via an ECMO system outside the body.
At the same time, the doctors in Cologne placed Sebastian Jost on the high-priority list for a donor heart in the Eurotransplant area, which includes eight European countries. 'Before the transplant could be initiated, though, our colleagues in Cologne had to carry out extensive examinations,' says Prof. Dr Udo Boeken, Surgical Director of the Heart Transplant Programme at Düsseldorf University Hospital. 'The space conditions in the chest had to be clarified, as did the question of the immune status since the patient's immune system had already been suppressed since the first transplant.' The risk of rejection of the donor organ is higher with a second transplant. Fortunately, the results were satisfactory in each case.
Just four days later, the redemptive signal came: a suitable donor organ was available. 'Late in the evening, the night nurse and the doctor in charge delivered the news,' says Sebastian Jost, describing the situation. 'I still have tears of joy now.' He immediately informed his parents and was then transferred by intensive care transport to the University Hospital in Düsseldorf.
'Cologne and Düsseldorf cooperate very closely when it comes to heart transplants,' says Prof. Dr Artur Lichtenberg, Director of the Clinic for Heart Surgery in Düsseldorf. "All of the highly specialised pre-diagnostics are carried out in Cologne, the actual transplant is then performed in Düsseldorf, and the aftercare is again in Cologne. This arrangement benefits both clinics as well as the patients, who can be cared for close to home for large parts of their hospital stay."
As far as Sebastian Jost is concerned, the doctors are satisfied: 'The transplant and the days afterwards went like a picture book,' says Prof. Boeken. Around two weeks after the operation, Sebastian Jost's condition was so stable that he was able to move from the intensive care unit to the regular ward. Just a few days later, he was transferred back from Düsseldorf to Cologne.
'I see a lot of work ahead of me now,' says the 29-year-old heart patient, looking to the near future. 'Because I want to get back on my feet as quickly as possible.' Initially on a ward at Cologne University Hospital and soon as part of a rehabilitation programme.
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