On the occasion of XVI Organ Donation Day which is celebrated on Sunday 16 April, the Foundation for Your Heart dell’Anmco (National Association of hospital cardiologists) and the Tomorrow Heart Foundation of Sicch (Italian Society of Cardiac Surgery) will work alongside the Ministry of Health and the National Transplant Center in promoting organ donation for transplantation, making available to citizens the toll-free number 800.05.22.33 (April 16, from 10 to 12 and from 16 to 18) to speak with cardiologists and heart surgeons from Anmco and Sicchidentified by the Foundations, and find the answers to their doubts or questions on the subject.
Patients with heart failure who do not respond to or become refractory to conventional therapies may be candidates for what is known as replacement therapy, or heart transplantation. Heart transplantation is, to date, the treatment of choice for advanced heart failure and refractory to medical care, a well-established surgical procedure that has excellent survival results. Second Domenico Gabrielli, president of the Foundation for your heart and director of cardiology at the San Camillo hospital in Rome“we must realize that the possibility of carrying out a heart transplant depends on the possibility that there is a donor and that the donor’s heart is a healthy organ and compatible with the patient who will have to receive it. In fact – he underlines – a donor heart does not it can always be combined with every patient on the waiting list for a transplant, due to incompatibility between donor and recipient due to a difference in blood group or an important difference in physical constitution”.
“Unfortunately – highlights the president of the Foundation for your heart – not all patients who suffer from heart failure refractory to medical therapies can access the opportunity for heart transplantation. Based on the guidelines proposed by scientific societies and shared by the transplant centers of heart, there are in fact contraindications to transplantation linked to the presence of pathologies or clinical factors that negatively influence the outcome of the surgery and short-term survival”.
“Even today – continues Gabrielli – the number of donors is much lower than the patients waiting for a transplant and waiting times can be very long, especially in the absence of urgency. It follows that the mortality of patients on the list is very high. It is therefore necessary to promote donation awareness campaigns in order to offer a greater chance of survival to patients dramatically marked by the inexorable deterioration of their heart’s functionality. Donating your own organs after death allows you to save many lives”.
“Heart transplantation – he observes
Francesco Musumeci
president of the Fondazione Cuore Domani of Sicch and director of Cardiac Surgery and Heart Transplant Center of the San Camillo hospital in Rome – is a complex operation especially for the organizational aspects that involve a large number of professionals who have to interface and synchronize like the gears of a mechanical clock. The donor heart, once taken, must be transplanted within a short period of time due to its impossibility of being kept outside the body for a long time. It is calculated that between the sampling and the transplant, 3 hours should not be exceeded for the recovery of a function to be adequate”.
“Lately technology has come to meet the problem of preserving the heart, allowing the organ to be kept vital and performing for a longer time. It is possible today – recalls the specialist – to keep the heart perfused and therefore active and pulsating during the transport, waiting for it to be transplanted. This technology allows the donor heart to be transported even for distances that were traditionally considered prohibitive. In addition, it also allows a better evaluation of the function of the heart even when some clinical or diagnostic situations give rise to doubts about the effective use of the organ for transplantation”.
“After the transplant – remarks Musumeci – a careful and continuous system of clinical surveillance of the patient is essential, which continues beyond discharge, for life. After discharge, the patient must in fact perform a series of checks for the rest of his life clinical-instrumental by highly specialized doctors, to better maintain the function of the transplanted organ and therefore the personal state of health.In conclusion, it can be stated that heart transplantation is the life-saving therapy of choice in many cases of heart failure 10-year survival after transplantation is now 60%, with 90% of patients returning to a normal quality of life. This is demonstrated by the fact that some transplant patients have participated in marathons”.