One hundred transplanted hearts in two years at Wroclaw center

The initiator and originator of the creation of a heart transplant center in Wroclaw was Prof. Piotr Ponikowski, MD, rector of UMW and director of the Institute of Heart Diseases at the USK Wrocław. The Ministry of Health issued a positive decision on the matter on February 3, 2021. The University Clinical Hospital in Wroclaw was the sixth medical center in Poland to be granted the right to perform heart transplants. The first heart transplantation at the Wroclaw hospital was performed on February 25, 2021 by Dr. Roman Przybylski's team.

- At the time, we performed a spectacular and groundbreaking transplantation for the Wroclaw Medical University and the University Clinical Hospital," says Rector Professor Piotr Ponikowski.

- For me, a doctor who graduated 35 years ago, and my colleagues, this was a historic moment. I am glad that I was able to tell the rector, Professor Bogdan Lazarkiewicz, the doyen of surgery, who was the only one among those I know who worked with the founder of Polish cardiac surgery, Professor Victor Bross, what I had once promised him: that the Professor would live to see the day when I could tell him that we do heart transplants in Wroclaw," adds Professor Ponikowski.

Already in the first year that the Wroclaw center received approval from the Ministry of Health for heart attachments, i.e. in 2021, one in five heart transplants in Poland was performed at the USK Institute for Heart Diseases in Wroclaw. In 2022, 44 hearts were transplanted in Wrocław - the highest number in all of Poland for heart attachments in adults. As of June 9 this year, 82 men and 19 women had undergone heart transplants at the Wroclaw center. The median age of the patients was 53.5 - the youngest patients were 19, the oldest 73. 36 patients were over 60 years old at the time of transplantation, and three patients were 70 years old. Only 19 patients were transplanted on an elective basis, the remaining 81 patients were submitted for the procedure on an urgent basis. The Wroclaw hospital receives patients not only from the Lower Silesian region, but from all over Poland and even abroad. Sometimes these are so-called hopeless cases, disqualified by other centers.

Time is of the essence in heart transplants, and literally every minute counts - no more than three, maximum four hours must elapse between retrieval and implantation. A longer time of ischemia derails the chance of a successful transplant. The UKS in Wroclaw was the first transplant center in Poland to enlist the help of the Aviation Board of the Police Headquarters and use police helicopters to transport the organ from the farthest regions of Poland.

- Every transplantation is a fight against time, as many patients can no longer leave the hospital due to their condition. Transplants are performed when there are donors, so it is our moral duty to take advantage of the situation when an organ is submitted for donation. We are invaluably helped by the police when an organ needs to be transported from further afield," explains Professor Michal Zakliczynski, head of the Department of Heart Transplantation and Mechanical Circulatory Support at USK.

Cardiac reattachment is a procedure performed in patients with severe and irreversible heart damage, in whom all alternative treatment options have been exhausted. It is a method of the so-called "last chance. Unfortunately, it is used infrequently, as Poland, like most countries in the world, is struggling with the problem of organ harvesting. According to Poltransplant data, more than 400 people in our country await a new heart each year, but only 20 percent of patients get the chance for a new life. At the end of 2022, there were 411 patients on the national waiting list for heart transplantation.

Increasing the number of cells, tissues and organs collected and transplanted is to be served by the National Transplant Program adopted by the Council of Ministers on May 9, 2023. National Transplantation Program for 2023-2032.

Its important premise is to raise public awareness of the importance of transplantation as a method of treatment, while taking into account educational actions concerning the legal solutions in force in Poland regarding donation. Indeed, in Poland, as in most countries, there is a model of presumed consent for organ donation. It assumes that if a deceased person has not objected to the donation of his or her organs after death, he or she is deemed to have consented to such an eventuality. Practice shows, however, that it is very common for doctors to ask the deceased's family for consent to organ donation.

The Medical University of Wroclaw and the University Clinical Hospital (USK) in Wroclaw came up with the idea of creating a Donor Monument to symbolize and honor all those who gave a chance for new lives to completely unknown people by allowing organ donation after their death.