The Alfred has been a leading transplant centre for heart transplantation since 1988 when the first heart transplant was performed here.
Led by Professor Don Esmore (cardiac surgeon) and Dr Peter Bergin (transplant cardiologist) the heart transplant service has grown since the early days with a total of 597 transplants to end 2011 and an average of 22 heart transplants per year in the last 10 years. In addition there have been 5combined heart-kidney transplants, 4 retransplants and 25 heterotopic transplants performed at the Alfred. A heterotopic heart transplant involves attaching the transplanted heart onto the failing native heart so that it can provide additional pumping power. It is usually considered for patients whose pulmonary pressures are too high for standard (orthotopic heart transplantation or where there is a significant size mismatch).
Not surprisingly the ICU management of this very complex and often very sick group of patients can be challenging, and the ICU team is proud of the achievements in this area with good outcomes for this patient group in the sometimes difficult early post operative period. The utilisation of echocardiography is particular high in this patient group and is one of the reasons the unit has developed a strong echocardiography focus. Many of our potential transplant patients require additional mechanical support as they await their heart transplant. Occasionally this may be in the form of veno-arterial ECMO . For longer term support Left Ventricular Assist Device (LVAD) support may be necessary to enable the patient to survive until a donor heart is available.