Since 1989, the cardiac specialists at the Herz- und Diabeteszentrum NRW (HDZ NRW), Bad Oeynhausen, have so far performed 2,500 heart transplants. At over 80 heart transplants per year, the North-Rhine Westphalian hospital is easily the largest heart transplant center in Europe. The wealth of experience to be found at the Clinic for Thoracic and Cardiovascular Surgery (Director: Prof. Dr. Jan Gummert) includes over 130,000 major heart and coronary artery surgeries, as well as more than 4,000 implantations of artificial hearts and ventricular assist devices. In Bad Oeynhausen, the entire spectrum of cardiosurgical techniques is performed.
A heart transplant becomes necessary when the heart can no longer supply the organism with sufficient blood and oxygen. Nearly 52 years after the first human heart was transplanted in Cape Town, South Africa, for major heart centers treating high-risk patients with severe chronic failure of the left and/or right ventricle this surgery now counts as a routine intervention. The development of continually improving immunosuppressive medication, especially the introduction of cyclosporin A in Germany in 1982, has had a crucial impact on the quality of heart transplantation results over the last thirty years.
Heart transplant survival
Today, more than 60% of heart transplant patients are still alive ten years after surgery. For patients with severe cardiac failure, this intervention still represents the best possible treatment option. Excellent drug and palliative therapy, as well as the use of ventricular assist devices, have contributed enormously to the ability to bridge a very long waiting period until a donor heart becomes available. "An interdisciplinary specialist medical team which prepares a transplantation thoroughly, a carefully thought-through aftercare program, as well as close cooperation with the family practitioner are all crucial to success", explains Prof. Jan Gummert, Medical Director of the HDZ NRW. Prof. Gummert is also Director of the Clinic for Thoracic and Cardiovascular Surgery, where in addition to complex clinical and outpatient monitoring, the spectrum of care includes seminars held by psychologists and experienced transplantation counsellors. The patients of all ages currently receiving regular aftercare in Bad Oeynhausen include around 120 heart transplant recipients whose surgery was more than 20 years ago.
Plea for opt-out system
"In theory, anybody can be affected by a severe heart disease which leaves transplantation as the only hope of survival", Professor Gummert emphasises. At the HDZ NRW Clinic for Pediatric Cardiosurgery and Congenital Heart Defects (Director: Dr. Eugen Sandica), transplants are also performed on infants, children and adolescents. So far this year, eight patients aged between 0 and 18 years have undergone successful transplantation.
"More than 200 HDZ NRW patients are currently waiting for a donor heart", Prof. Gummert and Dr. Sandica report. "Thanks to the possibilities offered by artificial ventricular assistance, we are often able to bridge the waiting period. Unfortunately, however, there are still far too few donor hearts available." In Germany, the current requirement is more than 1,200 donor hearts. From the standpoint of the HDZ NRW transplantation specialists, the introduction of an opt-out system in Germany could eliminate many practical problems, as experience in other countries has shown. Surveys reveal that around 80% of the population support organ donation. "This has to mean a clear consensus within society that my organs can be removed for donation when I die", Gummert explains. As President of the German Society for Thoracic, Cardiac and Vascular Surgery, he is actively campaigning for an opt-out system. "Anybody who does not agree with donation can opt out at any time. I view this not as a restriction of freedom or self-determination, but far more as respect for personal decision-making."
Herz- und Diabeteszentrum Nordrhein-Westfalen
Universitätsklinik der Ruhr-Universität Bochum
Press Office and Public Relations
Manager: Anna Reiss
D-32545 Bad Oeynhausen
Tel. 0049 5731 97-1955
Fax 0049 5731 97-2028