Ukraine performs first simultaneous heart and liver transplant on single patient

Historic success for Ukrainian doctors

For the first time in the history of Ukrainian medicine, a medical team performed a simultaneous heart and liver transplant on a single patient. This was announced by the Kyiv City Department of Healthcare. The procedure was carried out at the First Kyiv City Clinical Hospital.

«Мультидисциплінарна команда лікарів Київської міської клінічної лікарні №1 уперше в історії України успішно виконала одномоментну трансплантацію комплексу “серце-печінка” одному пацієнтові», — йдеться в офіційному повідомленні. (A multidisciplinary team of doctors from the First Kyiv City Clinical Hospital has successfully performed a simultaneous ‘heart-liver’ complex transplant on a single patient for the first time in Ukraine's history, the official statement reads.)

The course of the complex operation

The surgical intervention lasted approximately 15 hours. The patient received a heart transplant first, followed by a liver transplant. An artificial circulation device was used to support blood circulation at both stages.

The greatest challenge was ensuring stable haemodynamics during the liver transplant, when surgeons temporarily clamp the inferior vena cava. To minimise risks and create conditions for the recovery of both organs, the doctors had previously planned a transition from artificial circulation to venoarterial extracorporeal membrane oxygenation (ECMO). This technology allows for the maintenance of blood circulation and oxygen saturation of the blood. Thanks to careful planning, the equipment connection scheme allowed for a switch to ECMO without additional venous cannulation.

Patient condition and case details

As explained by Maksym Pavlovskyi, the medical director for anaesthesiology, transplantation, and high-tech medical care at the First Kyiv City Clinical Hospital and head of the programme, the operation was performed on a 44-year-old Kyiv resident diagnosed with severe heart and liver diseases.

As early as 2018, the man was added to the waiting list for a combined transplant in Minsk, but he never received the necessary care. Subsequently, his condition deteriorated critically: his ejection fraction dropped significantly, cardiovascular and liver failure progressed, and numerous life-threatening haemorrhages occurred from varicose veins in the oesophagus. The only chance of salvation was the transplantation of both organs.

On the first day after the operation, the patient was disconnected from the artificial lung ventilation machine. He was conscious, breathing independently, sitting up, and eating. Currently, the patient's condition is stable, and he remains in the intensive care unit.

The role of the donor and the significance of the intervention

The organ donor was a young man who suffered a haemorrhagic stroke, after which doctors declared brain death. To stabilise the donor's condition and buy time for organ retrieval, medical staff had to urgently apply ECMO, which allowed them to support his vital functions.

Simultaneous heart and liver transplantation is one of the most complex surgical interventions in modern medicine, performed only in a limited number of specialised centres worldwide. This operation required continuous monitoring of haemodynamics and bleeding, as well as close coordination of efforts by cardiac surgeons, transplantologists, anaesthesiologists, and perfusionists — specialists who ensure the operation of extracorporeal support devices.

The first combined transplant of this type in Ukraine has become an important step in the development of national transplantation and the expansion of high-tech medical care capabilities.