The term Heart Failure (CI) or Heart Failure (SC) indicates the clinical manifestation characterized by a bad function of the heart, which, despite correct therapy, is no longer able to ensure an adequate blood supply to the whole body. CH represents the terminal stage of many heart diseases, affecting about 2% of the general population; in Europe there are almost 15 million patients affected by this pathology, over one million in Italy. Despite the great therapeutic progress achieved in recent years, its prevalence is constantly growing due to the aging of the population and the successes achieved in the treatment of diseases in their acute phase. The prognosis of this condition is still very poor with a 5-year mortality rate of approximately 50%. Furthermore, CI represents an important share of health expenditure in all Western countries.
In its more advanced stages, it is characterized by continuous hospitalizations and a deterioration in the quality of life, leading to a fatal terminal stage. Patients with IC who do not respond and become refractory to conventional therapies may be candidates for a so-called replacement therapy, i.e. heart transplantation. Heart transplantation is, to date, the treatment of choice for advanced heart failure and refractory to medical treatment, it is a well-established surgical procedure that has excellent survival results. On the occasion of the 16th Organ Donation Day, the ANMCO Foundation for Your Heart and the SICCH Heart Tomorrow Foundation wish to be alongside the Ministry of Health and the National Transplant Center, directed by Dr. Massimo Cardillo in the promotion of organ donation for transplantation.
The professor. Domenico Gabrielli – President of the ANMCO Foundation for Your Heart and Cardiology Director of the S. Camillo Hospital in Rome – declares: “We must realize that the possibility of carrying out a heart transplant depends on the possibility that there is a donor and that the heart of the donor is a healthy organ and compatible with the patient who will have to receive it. In fact, the heart of a donor is not always combinable with every patient on the waiting list for a transplant. due to incompatibility between donor and recipient due to a difference in blood group or due to an important difference in physical constitution”.
“Unfortunately – underlines prof. Gabrielli – not all patients suffering from heart failure refractory to medical therapies can access the opportunity for heart transplantation. On the basis of the guidelines proposed by scientific societies and shared by heart transplantation centres, there are in fact contraindications to transplantation linked to the presence of pathologies or clinical factors which negatively influence the outcome of surgery and short-term survival”.
“Even today – continues prof. Gabrielli – the number of donors is much lower than the number of patients waiting for a transplant and waiting times can be very long, especially in the absence of urgency. It follows that the mortality of patients on the list is very high. It is therefore necessary to promote “donation awareness campaigns in order to be able to offer a greater chance of survival to patients dramatically marked by the inexorable deterioration of their heart’s functionality. Donating your organs after death saves many lives.”
In 2021, the threshold of 10 million declarations of intent registered in the SIT was exceeded. The flow from municipalities has also increased. In 2021 there were 3,201,540 declarations (2,204,318 consents and 997,222 oppositions). Although with an increasing trend, only 21.6% of adults registered their will with the municipality with a lower proportion in the southern regions. What is more serious to note is the consistent rate of opposition to the donation recorded which continues to be high especially in the southern regions. In 2021 this figure stood at 28.6% of reports and led to the exclusion of 730 potential donors.
“Heart Transplant – declares prof. Francesco Musumeci – President of the Fondazione Cuore Domani of SICCH and Director of Cardiac Surgery and Heart Transplant Center of the S. Camillo hospital in Rome – is a complex intervention especially for the organizational aspects that involve a large number of professionals who have to interface and synchronize like the gears of a mechanical watch. The donor heart, once taken, must be transplanted within a short period of time due to its impossibility of being kept outside the body for a long time. It is calculated that 3 hours should not be exceeded between the sampling and the transplant so that the recovery of a function can be adequate.
Technology has recently met the problem of preserving the heart, allowing the organ to be kept vital and performing for a longer time. It is now possible to keep the heart perfused and therefore active and pulsating during transport, waiting for it to be transplanted. This technology allows the donor heart to be transported over distances that were traditionally considered prohibitive. In addition, it also allows for a better evaluation of the heart’s function even when some clinical or diagnostic situations give rise to doubts about the effective use of the organ for transplantation”.
“After the transplant – continues prof. Musumeci – a careful and continuous system of clinical surveillance of the patient is essential, which continues beyond discharge, for life. In fact, after being discharged, the patient must perform a series of clinical-instrumental checks by highly specialized doctors for the rest of his life to best maintain the function of the transplanted organ and therefore his personal state of health.
In conclusion, it can be stated that heart transplantation is the life-saving therapy of choice in many cases of advanced heart failure. Survival 10 years after transplantation is now 60%, with 90% of patients returning to a normal quality of life. This is demonstrated by the fact that some transplant patients have participated in marathons!”.
The initiative is promoted by the HCF Onlus Foundation for Your Heart and by the Fondazione Cuore Domani, which will make the toll-free number 800 05 22 33 available; Citizens will be able to access this number on Sunday 16 April from 10 to 12 and from 16 to 18 to speak with Cardiologists and Heart Surgeons of ANMCO and SICCH, identified by the Foundations, to find answers to their doubts or questions on the subject.