Heart transplantation

1783 “mystical” first heartbeats at Vienna General Hospital

Walter Weiss has been living with a donor heart for 39 years, "a completely normal life, I would say."

(Bild: Medizinische Universität Wien/APA-Fotoservice/Hörmandinger)

Hearts have been transplanted at Vienna General Hospital for 40 years. Compared to those days, today's circumstances are "a miracle", according to Austria's oldest person with a donor heart. However, the operations are still not part of everyday life - neither for the doctors nor for the patients.

Even for Chief Intensive Care Physician Edda Tschernko, it is "mystical and very beautiful every time a heart begins to beat in a new body". On average, a heart transplant is performed at Vienna General Hospital almost every week, and has been for exactly 40 years. Patients are operated on "from newborns to old age", says Daniel Zimpfer, Head of Cardiac Surgery at the AKH - with ever-improving results.

A "completely normal" second life
1783 operations have been performed so far, the last one on a child just the night before the anniversary press conference. The transport container (pictured below) for the donor heart on display was still cool. Patient number five in 1985 was Walter Weiss. He has been living "a completely normal life again for 39 years, I would say - I can cycle, I can hike, I have traveled all over Europe in a camper van, all the way to the North Cape." But now he is slowly having to restrict himself. This is probably due to his age. That's why he has now bought an e-bike. Mr. Weiss will be 80 years old in May.

In the 1980s, donor hearts were still transported in normal camping coolers (left in the picture). Today, sophisticated technology is available (right).

(Bild: Medizinische Universität Wien/APA-Fotoservice/Hörmandinger)

For Mr. Weiss, his life with a donor heart is still "a miracle", mainly thanks to medical advances over the last four decades. In the beginning, he had to laboriously mix his own medication with serious side effects - "that wasn't pleasant" - but today there are relatively well-tolerated tablets. Andreas Zuckermann, head of the heart transplant program at the AKH, confirms that the greatest progress has been made in this area in the last four decades: "Rejection reactions are de facto hardly an issue today."

Medical progress gives hope
In Zuckermann's view, the future of transplant medicine also lies in ever better drugs against rejection reactions: perhaps with personalized drugs in the future, which are "tailored" to the patient personally by artificial intelligence. But progress is also being made in the preservation of donor hearts. In April, tests will begin at the AKH with a container that artificially keeps a donor heart beating and therefore also allows longer transportation routes.

Andreas Zuckermann, Walter Weiss, Daniel Zimpfer and Edda Tschernko

(Bild: Medizinische Universität Wien/APA-Fotoservice/Hörmandinger)

In 1985, Mr. Weiss was the exception, today successful operations are the rule: three quarters of patients are now given a new lease of life for at least ten years with transplants. Mr. Weiss muses in amazement that he thought back then that he would never see his three-year-old and eleven-year-old sons grow up: "Today they are also older gentlemen." At a symposium at which the AKH is looking back on 40 years of heart transplants, he will soon meet his two surgeons from back then again.

To this day, the transplants are always accompanied psychologically, as they always involve hearts that have stopped beating in someone else's body. Dealing with relatives is extremely delicate, confirms intensive care physician Tschernko. The recipients also receive psychological support: not only their body, but also their soul has to accept the new heart - even if times have also changed in this respect: Nowadays, no patient knows who their heart comes from. It was different for Mr. Weiss: he is aware that the heart beating in his chest is that of a 26-year-old woman whose life ended in 1985.