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Department of Transplantation

Overview

Outline of the Department of Transplantation

The Department of Transplantation, mainly comprising cardiologists, provides multidisciplinary treatment to patients for whom conventional methods cannot provide life-saving treatment options. These patients are often afflicted with acute and severe symptoms of heart failure such as fulminant myocarditis and other conditions associated with cardiogenic shock syndrome. The offered multidisciplinary therapies range from mechanical circulatory support in the form of a left ventricular assist device (LVAD) for patients with heart failure to an LVAD with heart transplant for patients with dilated cardiomyopathy and chronic severe heart failure following myocardial infarction.

At our department, we actively accept patients referred from hospitals across Japan. Upon receiving the referral of a patient with severe heart failure, the department personnel are promptly dispatched to the referring medical institution for consultation on treatment policy. The patient is then presented with treatment options and related information. If LVAD implantation or heart transplant is deemed necessary, the patient's family is provided with relevant information on the treatment, and the patient is rapidly transported (on the same day in some cases) to the NCVC to proceed with the treatment. (Patients requiring circulatory support, such as intra-aortic balloon pump or extracorporeal membrane oxygenation, may be transported via NCVC's medical service vehicle.)

At the Department of Transplantation, actual clinical care is delivered in collaboration with the Divisions of Cardiovascular Internal Medicine and Cardiovascular Surgery, along with other divisions within the NCVC Hospital if needed. As of June 2016, we had performed over 300 LVAD implantations and 82 heart transplants (Fig. 1). Since the recent acceptance of the implantation of non-pulsatile implantable ventricular assist devices for health insurance reimbursement as a "bridge-to-transplant"therapy, we have received many patients who have been referred to the department for the treatment of severe heart failure, resulting in nearly 30 LVAD implantations per year.

We are also actively treating children with severe heart failure. We have thus far implanted EXCOR® (a mechanical circulatory support system for children) in four patients and have performed heart transplant in a 6-year-old girl in April 2016.

Furthermore, we perform organ transplant. Following the establishment of a tissue bank within the NCVC, we are in charge of tissue transplant using heart valve tissue and vascular homografts. To establish tissue transplant as a therapeutic option, we have formed the West Japan Tissue Transplant Network in collaboration with other tissue banks in the region. The commencement of health insurance coverage for tissue transplant in April 2016 has allowed the execution of the procedure at many medical facilities. We intend to do our best to further improve medical care using this technique.

Fig. 1 Number of heart transplants performed at the NCVC and in Japan

Facility designation

  • Facility authorized to perform heart transplant (including surgery on children aged <10 years)
  • Facility authorized to implant ventricular assist devices
  • Facility authorized to implant ventricular assist devices in children
  • last updated : 2022/08/05

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