A total of 1800 heart transplants have been performed at University Hospital Vienna (AKH) and MedUni Vienna over the past 40 years. One of these, however, represents a special milestone: It is the first successfully performed AB0 incompatible heart transplant in an infant in Austria. The almost one-year-old patient was transplanted with a donor heart that did not match his blood group. This highly complex procedure was only possible thanks to years of preparation, the expertise of ten multidisciplinary teams from University Hospital Vienna and MedUni Vienna and the ongoing support of Lori West, the developer of the technology used.
The success of a heart transplant with an AB0 incompatible donor heart depends crucially on a low number of antibodies against the blood group that could reject the transplanted heart. The procedure was performed on an infant under two years of age, as very few antibodies against other blood groups are produced at this age. Nevertheless, it is necessary to specifically remove these antibodies both during the operation and in the follow-up treatment to ensure the success of the transplant. This is achieved with the help of a special filter technology developed by Canadian Lori West. During the transplant, the antibodies are selectively removed by the filter in the heart-lung machine. During the inpatient stay after the operation, the antibodies are continuously monitored and filtered again if necessary.
The successful implementation of this procedure required intensive and long-term preparation. Over a period of five years, a core group consisting of Nina Worel (Department of Transfusion Medicine and Cell Therapy), Johann Horvat (Senior Cardiotechnician and Transplant Coordinator) and Andreas Zuckermann (Department of Cardiac Surgery) developed a detailed protocol, which was introduced step by step. During this time, the participants were in constant contact with Lori West and the cardiac surgery department at Great Ormond Street Hospital in London. This close collaboration enabled them to successfully adopt and adapt both the necessary knowledge and the technology.
Outstanding medical performance thanks to multidisciplinary cooperation
Collaborations between different teams are not uncommon for MedUni Vienna and University Hospital Vienna, but in this case the collaboration was exceptional. "Thanks to meticulous preparation, close coordination and combined expertise, we were able to show that we are a leading center for pediatric transplantation - and thus give a young child a new perspective on life. This first successful procedure will be an immense improvement for many young children with heart defects in the future, as we can save their lives with this transplant," emphasizes Andreas Zuckermann, Head of the Heart Transplant Program.
The young patient is now doing well and has successfully completed his first outpatient check-up - a huge relief for his family in particular. "You can only understand what this team has achieved if you’ve been in a situation like this yourself," says Sabine G., the boy’s mother. "From the very beginning, my son was treated with so much love and care. Everyone did everything they could to make this operation possible and supported us every step of the way. There are no words to express my gratitude. Today, my son is full of joy and is making progress every day - a true gift."
