Transplant

November 21, 2024

Ukrainian team visits VUMC to hone transplant surgery skills

With the help of Vanderbilt and other transplant centers, Ukraine has developed a growing transplant program in the country in the last four years.

Vanderbilt’s Ashish Shah, MD (in white coat); with Ukrainian physicians, from left, Roman Buriak, MD, PhD; Vadym Mykolaienko, MD; Maksym Konodiuk, MD; Oleg Zhurba, MD, PhD; Yevhen Yarmilko, MD; and Vadym Golub, MD. (photo by Erin O. Smith) Vanderbilt’s Ashish Shah, MD (in white coat); with Ukrainian physicians, from left, Roman Buriak, MD, PhD; Vadym Mykolaienko, MD; Maksym Konodiuk, MD; Oleg Zhurba, MD, PhD; Yevhen Yarmilko, MD; and Vadym Golub, MD. (photo by Erin O. Smith)

For the third year, a delegation of doctors from Ukraine recently visited Vanderbilt University Medical Center to observe organ transplants and protocols.

With the help of Vanderbilt and other transplant centers, Ukraine has developed a growing transplant program in the country in the last four years. Historically, Ukraine’s transplant programs have been underdeveloped, as citizens needing transplants would typically leave the country for places such as India. But having a program in-country has become critical since travel became much more difficult after Russia invaded Ukraine in February 2022, said Oleg Zhurba, MD, PhD, chief of the Heart Surgery Department at Cherkasy Regional Cardiac Center in Ukraine.

The six-doctor delegation from Ukraine — including four surgeons and two anesthesiologists — observed all aspects of transplant, from traveling to distant hospitals to procure donor organs to observing the transplants themselves, including eight heart transplants. The Ukrainian delegation, which visited over the course of two weeks, was comprised of Oleg Zhurba, MD, PhD; Vadym Golub, MD; Maksym Konodiuk, MD; Vadym Mykolaienko, MD; Yevhen Yarmilko, MD; and Roman Buriak, MD, PhD.

“It is a great opportunity for us to be here,” Zhurba said, “and I would like to express our gratitude for this and for all who organized this … Seth Karp, (MD, chair of the Section of Surgical Sciences), Ashish Shah (MD, VUMC chief of Cardiac Surgery), and their powerful and great team.”

Observing large transplant centers such as the Vanderbilt Transplant Center is vital for the Ukrainian doctors, because such procedures require a large, multidisciplinary team using complex techniques, from obtaining donor organs to completing transplants. It is important for the team to not only witness the transplant surgeries themselves but understand the protocols that surround them. That includes how to determine who is a good candidate for a transplant, how to keep patients alive during transplants using extracorporeal life support, and how to manage patients posttransplant with frequent laboratory tests and a balance of multiple medications.

Transplant surgeons in Ukraine are working under extraordinary conditions, performing surgeries in dark hospitals as power grids have been shattered by war. They have treated thousands of wounded soldiers and civilians and slept for months in bomb shelters with their children and families and pets, determined to stay in their country and continue to save lives.

There are “a lot of problems facing us every day, especially the problems with the everyday missile attacks and drone attacks,” Zhurba said. The airspace is largely closed to civilian aircraft, meaning that donor organs must be transported on the ground. Yet traditional methods only allow organs to be preserved for about four hours, Zhurba noted. The Ukrainian team watched with great interest as the Vanderbilt transplant team demonstrated devices it is using to preserve organs for longer times and over greater distances, such as a special type of cooler that keeps the organ at 10 degrees Celsius.

“Our physicians have been developing cutting-edge technology to both improve donor organ viability and to increase the duration of time that organs can be stored prior to transplant. These innovations have been crucial to our growth and more importantly, our outstanding transplant outcomes,” said Joseph Magliocca, MD, director of the Vanderbilt Transplant Center.

“We view it as our responsibility to disseminate this information to improve transplantation globally,” continued Magliocca, who holds the Cindy and Dave Baier Directorship. “It is truly an honor to assist our colleagues from Ukraine in continuing to provide lifesaving care under almost unthinkable conditions. Our teams have learned as much from the Ukrainian experience as they have learned from ours. We look forward to continuing this valuable relationship.”

This transplant surgery experience exchange program between Vanderbilt and Ukraine was launched in 2022 through former U.S. Sen. Bill Frist, MD, founding director of the Vanderbilt Transplant Center; leadership of the Vanderbilt Transplant Center; Vasyl Strilka, MD, from the Ministry of Health of Ukraine; and Rostyslav Semikov, MD, founder of the Peace and Development Foundation.

Funding for the group’s travel and lodging was provided by the World Bank Group (International Bank for Reconstruction and Development) within the framework of the project “Strengthening the Healthcare System and Preserving Life” (HEAL Ukraine). It was partially supported by David Konrad.