Czech doctors perform first heart in a box transplant

Photo: archive of IKEM

A 65-year-old man from Prague became the first patient in the Czech Republic to successfully undergo a so-called heart in a box transplant. The surgery was performed by experts from the Institute of Clinical and Experimental Medicine early this month, using a pioneering method of organ retrieval that keeps the heart pumping outside the patient’s body for several hours.

The pioneering method of heart transplant, performed by doctors at Prague’s Institute of Clinical and Experimental Medicine, required two teams of doctors, three ambulances and a unique technology, known as beating heart in a box.

The heart was taken from a young woman who died in hospital in the Ústí nad Labem region, and was brought to Prague in a special device, which keeps the heart beating during the transportation from donor to recipient.

Zuzana Švarcová was in charge of coordinating the whole process:

“Normally, we have a tried and tested routine that we all know very well. But in this case, it wasn’t even clear whether the transplant would happen until the heart arrived at the Institute of Clinical and Experimental Medicine.”

Photo: archive of IKEM
In case of a traditional heart transplant, the organ is kept in an ice box and stops pumping while outside the body, which means its condition gradually deteriorates, explains cardiologist Jan Pirk:

“The death of a person often leads to a so-called catecholamine storm, which temporarily damages the heart, making it unfit for transplantation.”

The beating heart technology resuscitates the heart by pumping warm, oxygenated blood through the heart muscle, maintaining the heart in a good shape.

“We can control the inner environment of the heart, making the metabolism return to normal. After two or three hours, we can successfully donate it to the patient.”

While the traditional method of ice preservation allows the organ to last for a maximum of four hours, the heart in a box device keeps the organ alive for up to six hours.

As a result, organs can be retrieved from further afield, increasing the chance of recipients to receive the life-saving transplant.

At the moment, there are some 70 heart transplants performed in the Czech Republic each year with 40 of them performed at Prague’s Institute of Clinical and Experimental Medicine. Experts hope that the new method could increase the number of heart transplants by around one fifth.

Professor Ivan Netuka is chairman of the Department of Cardiovascular Surgery at IKEM:

Photo: archive of IKEM
“Our ambition is to increase the number of hearts suitable for our transplant programme by about one fifth, that means around eight or ten a year.”

In the meantime, the heart in a box transplant can only be used in special cases due to its high cost, reaching one and a half million crowns for each surgery.

The first patient to receive a new heart using the pioneering technology is reported to be in good condition. He should be released from hospital within a few days.