Heart transplantation in times of war

International cooperation in cutting-edge medicine: Renowned surgeon Professor . Dr Borys Todurov reports on how his team is continuing transplant programmes in Ukraine are being continued under the most difficult conditions. He and his team are undergoing further training at MHH.

Organ transplants have been saving people's lives and improving their quality of life for many years. They have also been part of medical care in Ukraine for more than 20 years. In 2019, renowned surgeon Professor orys Todurov, Director of the Kiev Heart Institute, performed the first heart transplant on a child in Ukraine. This development has been severely jeopardised since the outbreak of war in Ukraine in February 2022.

Professor Todurov and four Ukrainian specialists will be visiting the Transplant Centre at Hannover Medical School (MHH) until 17 November 2024 to receive further training in surgical techniques and the use of modern equipment. The MHH, one of the largest transplant centres in Europe, has extensive expertise in organ preservation and the transplantation of heart, lungs, liver, kidney and pancreas.

Minister: "MHH sends a strong signal"

"MHH initiative shows what is possible when excellent medical research and humanitarian commitment come together," says Dr Andreas Philippi, Lower Saxony's Minister for Social Affairs, Labour, Health and Equality. "At a time when international solidarity is more important than ever, Hannover is sending a strong signal - for knowledge transfer, for cooperation and for cohesion in Europe."

Surgical team travels in converted bus

The transplant programmes in Ukraine are continuing under the most difficult conditions. Heart transplants are particularly affected because the time window between organ removal and transplantation can only be four to five hours. "Due to the war, we can no longer transport the organs by helicopter. The transport time for the organs by land is too long," reports Professor Todurov. "We have therefore removed some seats from the back of a bus to transport our seriously ill patients, our team and our equipment to the donor hospital. We bring the patients back to Kyiv for intensive care. We do our work, even when it's dangerous."

"For each operation, a driver, the surgeon and two assistant doctors, two anaesthetists, a perfusionist and a nurse travel through the war-ravaged country," Professor Todurov continues. "As the clinics and hospitals throughout the country do not have the specialised equipment for a heart transplant, the team brings equipment and materials with them. The bus has space for four boxes per service as well as a bypass machine, a heart-lung machine, heating and cooling devices, perfusion systems, monitors and surgical equipment."

Todurov and his team will be guests at MHH in 2020

"Heart transplantation in times of war is an enormous achievement," praises the Director of MHH Department for Cardiothoracic, Transplantation and Vascular Surgery, Professor Dr Arjang Ruhparwar. "Professor Todurov and his team already visited our clinic in 2020 and gained insights, particularly in the surgical field of heart and lung transplantation, intensive care and aftercare. In the meantime, close contact has been established with MHH on both the clinical and research side, especially with the Institute of Transplant Immunology."

Joint research project on the transport of donor hearts

In the summer, the transport van was in danger of breaking down. Professor Dr Christine Falk, Director of the Institute of Transplantation Immunology, organised a fundraising campaign for a new trolley and personally drove the bus to the Heart Institute in Kyiv with a humanitarian aid transport. The personal contact resulted in a joint research project to extend the transport times of the donor hearts and thus avoid transporting the patients. Todurov's team is currently testing special cool boxes for blood products for the transport of donor hearts, which enable constant and controlled cooling. My team is researching the immunological effects of this method on the damage caused to heart tissue during transport."

Organ preservation also a topic at the Hannover Transplant Summit

"Organ preservation and perfusion is a highly topical issue in transplant medicine," explains Professor Dr Moritz Schmelzle, Director of the Department for General, Visceral and Transplant Surgery and Head of the Transplant Centre. "The joint research project is part of the R-CUBE excellence initiative, which focuses on the regeneration, repair and replacement of organs. Organ preservation is also the central topic of our Hannover Transplant Summit, which will take place on 21 and 22 November 2024 in the Medical Park."

Broad support

Professor Todurov and his team's visit is supported by MHH Transplant Centre and the Volkswagen Foundation.

The humanitarian aid deliveries were supported by colleagues from clinics in Hannover, including Dr Martin Schott, Dr Dirk Hahne, Dr André Gottschalk, DIAKOVERE Friederikenstift, as well as Mariya Maksymtsiv and Pastor Roman Maksymtsiv from the parish of St Volodymyr in Hannover.

International meeting on transplantation

The "Hannover Organ Transplant Summit 2024 - Current Trends in Translational Research" will take place on 21 and 22 November 2024. At the symposium, experts from MHH and from Germany and abroad will present current research findings on topics including transplant oncology, graft remodelling and xenotransplantation. The conference venue is the Rotunda in the Medical Park Hannover.

Further information: https://www.hannover-transplant-summit.org

Text: Inka Burow

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