ISMETT: A Heart from Prague Saves Life of a Sicilian Patient

Transplant performed with Heart-in-a-box technology

The heart that enabled a Sicilian man to regain a normal life comes from Prague. The surgery was performed thanks to the seamless management of IRCCS ISMETT, using innovative technologies, and with the collaboration of an Italian and European network that primarily saw the involvement of the Sicilian Regional Transplant Center.

ISMETT’s organ procurement team included Marco Morsolini and Matteo Greco (cardiac surgeons), Rosalia Longo and Andrea Giunta (perfusionists), and Gianfranco Cappello (OR nurse). The team flew to Prague, traveling over 2,000 km, to evaluate a potential heart donor for a 59-year-old Sicilian man suffering from idiopathic dilated cardiomyopathy. In the past, the long transportation times from such a remote location would have made heart procurement impossible, as the prolonged myocardial ischemia would have impaired the graft’s function.

In this case, the procurement was carried out using the innovative “Heart-in-a-box” technology, a device inside which the graft is perfused with the donor’s blood, preserving its beating status. This device allows reducing the heart’s ischemic distress because during the transport the heart muscle continues to receive blood and oxygen for its metabolic functions. Additionally, biochemistry tests can be performed and data acquired to ensure a good heart function once it is transplanted. “Without the Heart Box technology,” explains Sergio Sciacca, head of the heart transplant program at ISMETT, “the organ procurement and subsequent transplant would not have been possible. The heart can only tolerate less than 4 hours of ischemia; however, this device extends the organ’s preservation time, making the transplant feasible.”

The patient is in good clinical conditions, and was discharged four weeks after the surgery. “It is truly moving to witness such a profound display of solidarity between distant and diverse countries,” observes Michele Pilato, director of the ISMETT Heart Center. “Today, the heart of a Czech citizen is beating in the chest of a Sicilian patient.” All this was made possible thanks to a great team work involving the National Transplant Center, the Regional Transplant Center, and the ISMETT Heart Team. A special thanks to the organ procurement team, whose dedication after 12 hours of work and approximately 6 hours of heart perfusion during transport preserved the organ, enabling it to be successfully used and rapidly resume its function. Today, Sicily ranks among the leading centers in Italy for the number of heart transplants performed. The hope is that awareness of organ donation will continue to grow in Sicily, reaching the levels of northern Italy. New technologies will enable us to explore uncharted territories, as was in this case, and expand the donor pool, offering hope to an increasing number of patients with end-stage heart disease.”