[Distant heart procurement in the Czech and Slovak Republics].

Heart transplantation (HTx) became an established treatment of the end stage heart failure. The limiting factor of transplantation activity is the availability of donors which could be expanded by multiorgan harvesting and distant heart procurement (DHP). In spite of the fact that only 4-5 hours of could ischaemia (CI) is favourable it is still acceptable to organize the DHP within the radius over 1000 km from a recipient hospital. Good co-ordination, he best communication and transportation technology are absolutely necessary. Only in the case when there is no local recipient on the waiting list fr the HTx we offer an organ abroad. Paediatric Transplant Center Motol has been offered such 19 heart donors since 1992. 7 of them were accepted and in 4 (donor age 10-40 y.) successful DHP was performed, the organs were transported (900-1100 km) and HTx were performed at Harefield Hospital, UK. CI was 4:20-5:05 hours (mean 4:36). Two organs were used for orthotopic HTx (OHTx), two for heterotopic HTx (HHTx). Two failed due to the acute rejection. One was successfully retransplanted, went into chronic renal failure and is maintained on dialysis. Another recipient died 1 w. after HHTx due to the failure of his own heart. One recipient has been living already 1 y. since his OHTx. This experience demonstrates the ability and competence to organize and perform the DHP by a local team even in our conditions. We consider it suitable and necessary prerequisite to be able to start our own paediatric HTx programme.