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Ireland’s first ever heart and liver transplant has taken place

Teams from the Mater Hospital and St Vincent’s collaborated on this rare double transplant 

Martin Malinowski from Co. Monaghan is the first person in Ireland to receive a combined heart and liver transplant, thanks to organ donation. The 30 year old underwent the highly complex dual organ transplant surgery before Christmas at the Mater Hospital. He is now making great strides with his recovery.

Two surgical transplant teams – one from the Mater Misericordiae University Hospital’s National Heart and Lung Unit. The other from St Vincent’s University Hospital’s (SVUH) National Liver Transplant Unit. They worked together on this life saving operation for Martin.

Martin, who is originally from Poland but has lived in Ireland for 13 years. He was diagnosed in early 2019 with cirrhosis of the liver, due to Hepatitis C. The cirrhosis subsequently caused significant strain to Martin’s heart. He went on to develop cardiomyopathy, which led to the chambers of his heart enlarging. It was unable to pump blood efficiently around his body (heart failure).

Martin spoke about the transplant:

“After a year and a half of difficulties with my health, in the summer of 2021 my condition took a serious turn for the worse. I had to be immediately admitted to hospital with a critically low heartbeat. I had to have an ICD (implantable cardioverter-defibrillator) inserted to regulate my heart and I was quickly put on the transplant list by my medical team.”

According to Dr Emer Joyce, Transplant Cardiologist at the Mater Hospital, initial assessments showed that Martin had two independently serious conditions. They were also impacting on one another, causing Martin’s condition to progress more rapidly. Although having more than one severe organ disease can result in a patient being ineligible for a transplant, due to the increased risks associated with multi-organ transplant, heart failure related to cirrhotic cardiomyopathy is one of the rare indications where combined heart and liver transplant can be considered.

Dr Joyce said:

“A heart and liver transplant is a major undertaking for a the team and it is an extremely rare procedure. There is around 200 ever taking place in the US, and much smaller numbers worldwide. Once Martin was identified as a potential eligible candidate, our heart team at the Mater worked closely with our colleagues at St Vincent’s on highly detailed planning, protocol and procedures across multiple multidisciplinary meetings to prepare for the best possible chance for a successful outcome for Martin.”

Dr Zita Galvin, Transplant Hepatologist at SVUH, discussed the complexity of the procedure.

“This procedure had never before been attempted in Ireland. There is limited world-wide experience. Every aspect of Martin’s care including the pre-transplant course, donor selection process, transplant operative details and post-operative critical care course were carefully discussed and planned”

Martin was at home in Castleblayney when he received the call. His transplant took place at the Mater Hospital late last year. The surgery began with Mr Jonathan McGuinness and his team at the Mater Hospital performing the heart transplant, followed by Mr Justin Geoghegan of SVUH transplanting the liver from the same donor.

Multiple medical professionals, including surgical, anaesthesiology, intensivist, medical, nursing, laboratory and transplant coordinator personnel from both hospitals were involved in Martin’s care. While in recovery, teams from the Mater and SVUH took part in twice daily multidisciplinary and multisite rounds.

The operation was a resounding success and after spending a month in recovery at the Mater, Martin was discharged home. Now, he is already seeing the substantial benefits of his new heart and liver and is getting back to normal.

He said:

“I am truly grateful to my transplant and medical teams at the Mater and SVUH. But especially, I want to thank my donor for giving me a second chance. Without them, I would not be here today, plain and simple. Now I can look forward to the next stage of my life.”

The teams from the Mater and SVUH are delighted at how well Martin has done and how quickly he has recovered. No small part due to his amazing determination and positive attitude.

Dr Joyce praised Martin’s courage and commitment to his intensive medical regimen both before and since the transplant. “Martin has a wonderful appreciation and methodical way of managing his condition. He has recovered extraordinarily well from the transplant. The fact that this is a first for Ireland and that it took place during the Covid-19 pandemic really highlights how strong Ireland’s teams are and the importance of cross-hospital collaboration.”

Dr Galvin concurred:

“This achievement is an exciting new chapter for transplant in Ireland. It was made possible because of the hardwork and dedication of the multidisciplinary team across both hospitals. Therefore, it is a fantastic example of teamwork and interhospital collaboration.”

Professor Jim Egan, Director of the HSE’s Organ Donation Transplant Ireland said, “Organ donation saves lives. Martin’s remarkable recovery and the fact that this is the first heart and liver transplant performed in Ireland is only made possible through organ donation. We would ask everyone to discuss this life saving issue with their families.”

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