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Updated: Aug 20, 2026
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
Orthotopic heart transplantation with concurrent coronary artery bypass grafting or previous stent implantation
1Deutsches Herzzentrum Berlin, Department of Thoracic and Cardiovascular Surgery, Augustenburger Platz 1, 13353 Berlin, Germany. Musci@dhzb.de
Insights
Donor hearts with pre-existing coronary artery disease can be safely transplanted after bypass grafting or stenting. This approach effectively utilizes viable donor organs, improving transplant outcomes for select recipients during organ shortages.
Area of Science:
- Cardiology
- Transplant Surgery
- Vascular Medicine
Background:
- Donor hearts with pre-existing coronary artery disease (CAD) pose a challenge in organ transplantation.
- These organs are often declined, limiting the donor pool and transplant opportunities.
Purpose of the Study:
- To evaluate the safety and efficacy of transplanting donor hearts with pre-existing CAD.
- To assess the long-term outcomes of using treated donor hearts in orthotopic transplantation.
Main Methods:
- Three cases of donor hearts with diagnosed CAD prior to transplantation are presented.
- Two hearts underwent coronary artery bypass grafting (CABG) during the transplant procedure.
- One heart received angioplasty with stenting during donor screening angiography.
Main Results:
- All three donor hearts were successfully transplanted after intervention.
- Patients experienced uneventful post-operative courses.
- Coronary angiography at early and late follow-up (up to 43 months) confirmed the patency of bypass grafts and stents.
Conclusions:
- Donor hearts with CAD requiring bypass grafting or stenting can be safely and effectively utilized.
- This strategy expands the donor organ pool, particularly crucial in times of organ shortage.
- Careful recipient matching based on age and medical condition is essential for successful outcomes.
Abstract:
We describe three cases of donor hearts with preexisting coronary artery disease already diagnosed prior to transplantation: two were treated by coronary artery bypass grafting during the transplant procedure and one by angioplasty with stenting during the donor screening angiography. All three donor organs would otherwise have been rejected, depriving potential recipients of organ transplantation. All patients had an uneventful post-operative course with follow-up completed 22, 40 and 43 months after orthotopic transplantation showing patency of the stent and bypass grafts in the early (1 and 9 months) and late (22, 24 and 37 months) coronary angiography. Our results suggest that in this era of acute organ shortage donor hearts requiring bypass or stenting, which form a small but significant donor subgroup, can be used effectively and safely when matched to the recipients' age and medical condition.
