Mechanical Circulatory Support Saves Lives – Five Years’ Experience of Eurotransplant Membership and Assist Device Program in Hungary

Cardiac transplantation has a history of 20 years at Semmelweis University however, no mechanical circulatory support was available until recently. Joining Hungary the Eurotransplant in 2012 as well as opening of a small heart failure and transplant unit was a game changing move in the history of Hungarian heart transplantation. The authors would like to report their five years’ experience in Eurotransplant and the results of cardiac assist device program.

From January 2012 till the end of year 2016 cardiac transplantation was performed at Semmelweis University in 213 cases. Thereby increasing transplant activity almost four times. At the same time period mechanical circulatory support was applied in 131 patients in 172 different settings. Indication for support were end stage heart failure refractory to medical treatment and acute left or right heart failure.

MCS treatment was initiated for acute graft failure after heart transplantation in 43 cases, for end stage heart failure in 52 cases, for acute myocardial infarction in 29 cases, for acute postcardiotomy heart failure in 24 cases, for severe respiratory insufficiency in 2 cases and for drug intoxication in one case. By the end of the 5^th year 56 patients are still alive from the 131 treated by MCS. Among the survivors 10 patients were successfully bridged to transplantation.

Optimal strategy and proper selection of available devices can cover all modalities of current bridge therapy of mechanical circulatory support and it adds significant survival benefit treating critically ill patients even in countries with narrow financial resources.