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Cardiac function after domino-donor heart transplantation
C M Kells1, S Marshall, M Kramer
1Department of Cardiothoracic Surgery, Stanford University School of Medicine, California 94305.
The American Journal of Cardiology
|January 1, 1992
Summary
Domino-donor cardiac transplantation, using hearts from heart-lung transplant patients, offers a promising solution to donor heart shortages. This method shows excellent survival and graft function, making it a viable option to expand the donor pool.
Area of Science:
- Cardiology
- Transplantation Surgery
- Pulmonary Hypertension
Background:
- Donor heart availability is a critical limitation in cardiac transplantation.
- Explanted hearts from heart-lung transplant recipients present a potential solution.
- Domino-donor transplantation leverages donor right ventricles adapted to pulmonary hypertension.
Purpose of the Study:
- To evaluate the feasibility and outcomes of domino-donor cardiac transplantation.
- To assess the impact of pre-existing pulmonary hypertension on donor right ventricular function.
- To determine if domino-donor transplants can augment the donor heart supply.
Main Methods:
- Seven domino-donor cardiac transplants were performed at Stanford University Hospital.
- Patient and graft survival were monitored.
- Right ventricular function and size were assessed post-transplantation.
- Infection and rejection rates were compared to conventional transplantation.
Main Results:
- 100% graft and patient survival at a mean follow-up of 20 months.
- Infection and rejection rates were comparable to conventional orthotopic transplantation.
- Right ventricular function and size improved or remained unchanged in all recipients.
- Transient right ventricular dilation occurred in patients with pre-operative pulmonary hypertension.
Conclusions:
- Domino-donor cardiac transplantation is a safe and effective method to increase donor heart availability.
- Adequate pre-operative assessment is crucial for successful outcomes.
- This approach demonstrates excellent short-term graft and patient survival.