Heart Transplantation in Belarus

  • Yu. P Ostrovsky Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus
  • L. V. Rachok Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus
  • I. A. Grebenyuk Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus
  • E. K. Kurlyanskaya Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus
  • A. V. Valentyukevich Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus
  • O. G. Chernookiy Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus
  • L. G. Shestakova Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus
  • V. S. Khudnitskaya Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus
  • T. A. Dubovik Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus
  • M. G. Kolyadko Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus
Keywords: terminal stage of heart failure, heart transplantation, auxiliary mechanical support of blood circulation

Abstract

Objective. To evaluate the effectiveness of the treatment of patients with end-stage heart failure.
Materials and methods. In total for the period from 2009 to 2019, 3038 potential recipients of donor heart were examined, of which 22% were put on a waiting list of transplantation. Orthotopic heart transplantation was performed in 326 patients, which accounted for 40% of the total number of patients on the waiting list for a ten-year period.
Results and discussion. During the period from 2009 to 2019, orthotopic heart transplantation in Belarus on the basis of the Scientific-Practical Center «Cardiology» was performed for 326 patients with terminal heart failure. The preference was given to the biatrial technique (89%), only 30 patients were operated on using the bicaval technique (11%). The duration of artificial blood circulation was 250 + 24 min. The patient’s stay after heart transplantation in the intensive care unit and reanimation was 9 + 3 days, while the duration of artificial respiration was 10 + 6 hours on average. The hospital period averaged 23 + 6 days. The average for 10 years the hospital mortality rate was 8.4%, and in the period from 2016 to 2019 did not exceed 7.2%. The dynamics of survival rates are presented graphically in the diagram.
Findings. Currently, the achievements of transplantology have allowed us to achieve some success in the struggle for the lives of patients, which a few decades ago, medicine could only dream of. Today, the team of cardiac surgeons and cardiologists is faced with the task of finding methods to ensure the longest life expectancy of the donor organ by reducing the risk of various complications, as well as developing new technologies that will maximize the life expectancy of patients with terminal heart failure in anticipation of an optimal donor heart.

References

  1. Katz JN, Waters SB, Hollis IB, Chang PP. Advanced therapies for end-stage heart failure. Curr Cardiol Rev. 2015;11(1):63-72. https://doi.org/10.2174/1573403x09666131117163825
  2. Kittleson MM. Changing Role of Heart Transplantation. Heart Fail Clin. 2016 Jul;12(3):411-21. https://doi.org/10.1016/j.hfc.2016.03.004
  3. Prinzing A, Herold U, Berkefeld A, Krane M, Lange R, Voss B. Left ventricular assist devices-current state and perspectives. J Thorac Dis. 2016 Aug;8(8):E660-6. https://doi.org/10.21037/jtd.2016.07.13
  4. Aaronson KD, Patel H, Pagani FD. Patient selection for left ventricular assist device therapy. Ann Thorac Surg. 2003 Jun;75(6 Suppl):S29-35. https://doi.org/10.1016/s0003-4975(03)00461-2
  5. Kirklin JK, Naftel DC, Pagani FD, Kormos RL, Stevenson LW, Blume ED, et al. Sixth INTERMACs annualreport: a 10,000-patient database. J Heart Lung Transplant. 2014 Jun;33(6):555-64. https://doi.org/10.1016/j.healun.2014.04.010
  6. Deschka H, Holthaus AJ, Sindermann JR, Welp H, Schlarb D, Monsefi N, et al. Can Perioperative Right Ventricular Support Prevent Postoperative Right Heart Failure in Patients With Biventricular Dysfunction Undergoing Left Ventricular Assist Device Implantation? J Cardiothorac Vasc Anesth. 2016 Jun;30(3): 619-26. https://doi.org/10.1053/j.jvca.2016.02.023
  7. John R, Lee S, Eckman P, Liao K. Right ventricular failure--a continuing problem in patients with left ventricular assist device support. J Cardiovasc Transl Res. 2010 Dec;3(6):604-11. https://doi.org/10.1007/s12265-010-9216-4
  8. Cushing K, Kushnir V. Gastrointestinal Bleeding Following LVAD Placement from Top to Bottom. Dig Dis Sci. 2016 Jun;61(6):1440-7. https://doi.org/10.1007/s10620-016-4123-4
  9. Robertson J, Long B, Koyfman A. The emergency management of ventricular assist devices. Am J Emerg Med. 2016 Jul;34(7):1294-301. https://doi.org/10.1016/j.ajem.2016.04.033
  10. Castel MA, Cartañá R, Cardona M, Pereda D, Hernández M, Sandoval E, et al. Long-term outcome of high-urgency heart transplant patients with and without temporary ventricular assist device support. Transplant Proc. 2012 Nov;44(9):2642-4. https://doi.org/10.1016/j.transproceed.2012.09.107
  11. Barth E, Durand M, Heylbroeck C, Rossi-Blancher M, Boignard A, Vanzetto G, et al. Extracorporeal life support as a bridge to high-urgency heart transplantation. Clin Transplant. 2012 May-Jun;26(3):484-8. https://doi.org/10.1111/j.1399-0012.2011.01525.x
  12. D’Alessandro C, Golmard JL, Lebreton G, Laali M, Varnous S, Farahmand P, et al. High-urgency waiting list for cardiac recipients in France: single-centre 8-year experience. Eur J Cardiothorac Surg. 2017 Feb 1;51(2):271-278. https://doi.org/10.1093/ejcts/ezw291
  13. Kittleson MM, Patel JK, Moriguchi JD, Kawano M, Davis S, Hage A, et al. Heart transplant recipients supported with extracorporeal membrane oxygenation: outcomes from a single-center experience. J Heart Lung Transplant. 2011 Nov;30(11):1250-6. https://doi.org/10.1016/j.healun.2011.05.006
  14. Hullin R. Heart transplantation: current practice and outlook to the future. Swiss Med Wkly. 2014 Aug 7;144:w13977. https://doi.org/10.4414/smw.2014.13977
  15. Davis MK, Hunt SA. State of the art: cardiac transplantation. Trends Cardiovasc Med. 2014 Nov;24(8):341-9. https://doi.org/10.1016/j.tcm.2014.08.004
  16. Silva Enciso J. Mechanical Circulatory Support: Current Status and Future Directions. Prog Cardiovasc Dis. 2016 Jan-Feb;58(4):444-54. https://doi.org/10.1016/j.pcad.2016.01.006
  17. Yusen RD, Edwards LB, Kucheryavaya AY, Benden C, Dipchand AI, Goldfarb SB, et al. The Registry of the International Society for Heart and Lung Transplantation: Thirty-second Official Adult Lung and HeartLung Transplantation Report – 2015; Focus Theme: Early Graft Failure. J Heart Lung Transplant. 2015 Oct;34(10):1264-77. https://doi.org/10.1016/j.healun.2015.08.014
  18. Subramaniam K. Mechanical circulatory support. Best Pract Res Clin Anaesthesiol. 2015 Jun;29(2): 203-27. https://doi.org/10.1016/j.bpa.2015.04.003
  19. Sajgalik P, Grupper A, Edwards BS, Kushwaha SS, Stulak JM, Joyce DL, et al. Current Status of Left Ventricular Assist Device Therapy. Mayo Clin Proc. 2016 Jul;91(7):927-40. https://doi.org/10.1016/j.mayocp.2016.05.002
  20. Dang NC, Topkara VK, Mercando M, Kay J, Kruger KH, Aboodi MS, et al. Right heart failure after left ventricular assist device implantation in patients with chronic congestive heart failure. J Heart Lung Transplant. 2006 Jan;25(1):1-6. https://doi.org/10.1016/j.healun.2005.07.008
  21. Meineri M, Van Rensburg AE, Vegas A. Right ventricular failure after LVAD implantation: Preventionand treatment. Best Pract Res Clin Anaesthesiol. 2012 Jun;26(2):217-29. https://doi.org/10.1016/j.bpa.2012.03.006
  22. Estep JD, Cordero-Reyes AM, Bhimaraj A, Trachtenberg B, Khalil N, Loebe M, et al. Percutaneous placement of an intra-aortic balloon pump in the left axillary/subclavian position provides safe, ambulatory long-term support as bridge to heart transplantation. JACC Heart Fail. 2013 Oct;1(5):382-8. https://doi.org/10.1016/j.jchf.2013.06.002
  23. Cochran RP, Starkey TD, Panos AL, Kunzelman KS. Ambulatory intraaortic balloon pump use as bridge to heart transplant. Ann Thorac Surg. 2002 Sep;74(3):746-51; discussion 751-2. https://doi.org/10.1016/s0003-4975(02)03808-0
  24. Umakanthan R, Hoff SJ, Solenkova N, Wigger MA, Keebler ME, Lenneman A, et al. Benefits of ambulatory axillary intra-aortic balloon pump for circulatory support as bridge to heart transplant. J Thorac Cardiovasc Surg. 2012 May;143(5):1193-7. https://doi.org/10.1016/j.jtcvs.2012.02.009
  25. Briceno N, Kapur NK, Perera D. Percutaneous mechanical circulatory support: current concepts and future directions. Heart. 2016 Sep 15;102(18):1494-507. https://doi.org/10.1136/heartjnl-2015-308562
  26. Fuhrman BP, Hernan LJ, Rotta AT, Heard CM, Rosenkranz ER. Pathophysiology of cardiac extracorporeal membrane oxygenation. Artif Organs. 1999 Nov;23(11):966-9. https://doi.org/10.1046/j.1525-1594.1999.06484.x
Published
2020-12-16
How to Cite
Ostrovsky, Y. P., Rachok, L. V., Grebenyuk, I. A., Kurlyanskaya, E. K., Valentyukevich, A. V., Chernookiy, O. G., Shestakova, L. G., Khudnitskaya, V. S., Dubovik, T. A., & Kolyadko, M. G. (2020). Heart Transplantation in Belarus. Transplantation and Artificial Organs, (1(01), 61-78. https://doi.org/10.30702/transpaorg/05_20.0112/060-077/002
Section
SCIENTIFIC PUBLICATIONS