If we assume that a donor heart extends the life of its recipient by an average of 10 to 15 years, then the team at the Heart Transplant Programme at Düsseldorf University Hospital (UKD) has likely enabled around 5,000 additional years of life in recent years. This is because the 400th donor heart has recently been transplanted since the programme resumed in 2010.
In 2009, Prof. Dr. Artur Lichtenberg took over as Head of Cardiac Surgery at the UKD. One of his goals was to re-establish a heart transplant programme in Düsseldorf together with a dedicated team. However, it took almost a year to organise all the processes so that heart transplants could be performed again. There had already been periods in the late 1980s and between 1996 and 2001 when this procedure could be carried out at the UKD.
“Heart transplants – that’s not something you just do on the side,” says Prof. Lichtenberg. “It requires people with staying power, passion, and personal commitment. People who work tirelessly, day in, day out, to ensure that this vital service continues to be available in the future.” The team must be well-trained, flexible, and motivated across all disciplines and professional groups. Furthermore, close, trusting collaboration between cardiac surgery and cardiology, as well as the presence of an excellent anaesthesiology department and highly specialised nursing care, are essential prerequisites. “We can offer all these factors here at the UKD,” says Prof. Lichtenberg. “At this point, I would like to extend my heartfelt thanks to everyone who puts their heart and soul into this work.” The heart transplant programme at Düsseldorf University Hospital is now firmly in second place in Germany in terms of case numbers. Last year alone, the team transplanted 44 donor hearts.
“Many patients live for 25 years or more with a donor heart – usually without major complications,” explains Prof. Dr. Udo Boeken, surgical director of the heart transplant programme. “Despite the major operation, around 70 per cent of donor hearts are still functioning five years after the transplant. Heart transplantation, therefore, provides us with a surgical procedure that can give many people with so-called ‘end-stage’ heart failure numerous years of life.” One prerequisite: there must be organ donors willing to donate their organs.
More than 80 per cent view organ donation positively
“We could be significantly more successful if more people were to register as organ donors – either via the online organ donor register or simply by carrying an organ donor card,” says Prof. Boeken. More than 80 per cent of Germans have a positive attitude towards organ donation. In comparison, however, only a few have documented their positive stance. “That is why we have long waiting lists for seriously ill people who only have the chance of a largely unrestricted life with the help of a donor heart,” explains Prof. Boeken.
Patients whose condition is so critical that they are classified as high-priority on the waiting list receive inpatient care at the Heart Centre – and thus also from the cardiology team. In many cases, the patients have been known to the hospital for years. “From the diagnosis of heart failure through initial drug therapies to the provision of cardiac support systems and a joint artificial heart programme with cardiac surgery, here at the UKD, we can support all phases of care with the full spectrum of university-level treatment options,” explains Prof. Dr. Malte Kelm, Director of the Department of Cardiology, Pneumology and Angiology at the UKD. “In addition, patients benefit from the extensive research into heart failure carried out here at the site.”
Involvement of self-help groups and patient organisations
Close cooperation between cardiac surgery and cardiology is also important in the post-operative care phase. “Drawing on our extensive shared experience, we guide our patients through the post-transplant period and actively involve patient associations and self-help groups in this process,” says Prof. Dr. Amin Polzin, Senior Consultant in the Department of Heart Failure, Emergency and Critical Care Medicine at the Clinic for Cardiology, Pneumology and Angiology. The aim is to offer patients advice from a wide range of perspectives and to combine this with extensive diagnostic and therapeutic options.
Text/Photo ©UKD