Orthotopic retransplantation in heterotopic transplant recipients: 3 case reports

Area of Science:

• Cardiovascular Surgery
• Transplantation Medicine
• Cardiac Physiology

Background:

• Heart transplantation is a critical treatment for end-stage heart failure.
• Size mismatch can complicate initial heart allograft selection.
• Heterotopic transplantation is sometimes used as a primary strategy.

Observation:

• Three patients initially received heterotopic heart transplants due to size discrepancy.
• These patients later developed heart failure necessitating retransplantation.
• The original heterotopic graft was intentionally preserved during the second procedure.

Findings:

• A novel technique involved leaving the heterotopic graft in situ while performing orthotopic retransplantation.
• This approach facilitated the removal of the native heart and placement of the new allograft.
• The described method led to decreased postoperative morbidity.

Implications:

• This surgical strategy may offer an alternative for complex heart transplant cases.
• Preserving a heterotopic graft during orthotopic retransplantation can yield superior patient outcomes.
• Further research into this technique could refine heart failure treatment protocols.