First Experience of Orthotopic Heart Transplantation on South Ural

Mikhail Nuzhdin ¹, Ilya Melnikov ¹, Artem Tsarkov ², Natalya Safronova ², Yuriy Marchenko ³, Denis Loganenko ¹, Aleksey Barishnikov ⁴, Aleksey Fokin ⁵, Konstantin Kondrashev ⁶

¹ Chelyabinsk Regional Clinical Hospital, Department of Cardiac Surgery, Chelyabinsk, Russia; ² Chelyabinsk Regional Clinical Hospital, Department of Anaesthesiology, Chelyabinsk, Russia; ³ Chelyabinsk Regional Clinical Hospital, Department of Intensive Care, Chelyabinsk, Russia; ⁴ Chelyabinsk Regional Clinical Hospital, Department of Vascular Surgery, Chelyabinsk, Russia; ⁵ South Ural State Medical University, Chelyabinsk, Russia; ⁶ Regional Clinical Hospital, Centre of Cardiac Surgery, Ekaterinburg, Russia;

Date, time and location: 2018.05.25 15:30, Exhibition area, 1st Floor. Zone – A

Abstract

Objective: Heart transplantation is currently the gold standard surgical approach in the treatment of end-stage heart failure. We present our first experience of heart transplantation programm on South Ural.

Methods: From the beginning of 2016 efforts have been made to introduce the care system to enroll patients with end-stage heart failure, observe them and include in a waiting list. The programm has been started in Chelyabinsk Regional Clinical Hospital (Chelyabins, Russia). Since that time 6 patients were included in the waiting list. Consequetive examinations including laboratory tests, chest, abdomen, brain CT scan, right heart catheterization (to assess transpulmonary gradient, pulmunary vascular resistance, left atrium pressure, cardiac index, pulmunary artery pressure) has been made according to international (ISHLT) and national guidelines.

Results: In october 19, 2017 we performed the first orthotopic heart transplantation in patient with ischemic cardiomyopathy with ejection fraction 37%, left ventricle end-diastolic volume of 315 ml, pulmonary artery pressure of 70 mmHg and NYHA class IV. We utilized bi-caval technique. Early postoperative period without complication. After series of endomyocardiac biopsies the acute rejection was identified and succsesfully resolved after appropriate treatment. Patient was discharged from the hospital.

Conclusion: Heart transplantation programm has succsesfully started on South Ural. Currently, 10 patients are on waiting list. Only team work and multi-disciplinary approach are essencial in the beginning of the Programm. Future attemps will be made to promote the programm and make transplantation possible for more patients with end-stage disease.