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Updated: Jul 10, 2026
Functional Assessment of the Donor Heart During Ex Situ Perfusion: Insights from Pressure-Volume Loops and Surface Echocardiography
Published on: October 11, 2022
Survival is not compromised in donor hearts with echocardiographic abnormalities
Nikolai Sopko1, Kenneth J Shea, Kristen Ludrosky
1Case Western Reserve School of Medicine, Cleveland, Ohio, USA.
Insights
Heart donor echocardiographic abnormalities often resolve post-transplant, leading to excellent survival rates in heart transplant recipients. This study highlights the positive outcomes despite initial donor heart findings.
Area of Science:
- Cardiology
- Transplant Surgery
- Medical Diagnostics
Background:
- Echocardiographic abnormalities in heart donors can raise concerns about transplant outcomes.
- Assessing the impact of these abnormalities on recipient survival is crucial for donor selection and management.
Purpose of the Study:
- To evaluate the effect of echocardiographic abnormalities in heart donors on short- and long-term outcomes for heart transplant recipients.
Main Methods:
- A retrospective chart review of heart donors and recipients over a 6-year period.
- Analysis of donor demographic data, cause of death, and echocardiogram results.
- Querying recipient charts for pre-discharge echocardiograms and survival data.
Main Results:
- Of 485 heart transplants, 50 donors had 70 echocardiographic abnormalities (e.g., wall motion abnormality, hypertrophy, regurgitation).
- Post-transplant, 64% of these abnormalities resolved, with significant improvements in wall motion, hypertrophy, and mitral regurgitation (P < 0.01).
- Recipient survival was excellent at 96% at a mean follow-up of 4 years, despite initial donor abnormalities.
Conclusions:
- Most echocardiographic abnormalities in donor hearts resolve after transplantation.
- Heart transplant recipients demonstrate excellent long-term survival rates, even when donors have pre-existing echocardiographic findings.
Objectives:
To determine the effect of heart donors with echocardiographic abnormalities on short and long-term outcomes on heart transplant recipients.
Methods:
Retrospective chart review of heart donors used over 6 y. Donor charts provided demographic information, cause of death, and echo results. Recipient charts were queried for predischarge echo and survival results.
Results:
From January 1999 to December 2005, 485 heart transplants were performed. Of these, 50 donors had 70 echo abnormalities. Mean donor age was 32 y (range 4-51 y). Echo abnormalities included wall motion abnormality in 30 (60%), left ventricular hypertrophy in 20 (40%), mitral regurgitation in 16 (32%), aortic regurgitation in 2 (4%), and left ventricle dilation in 2 (4%). Mean ejection fraction was 54.0% (range 40%-70%). Echo abnormalities post-transplant decreased significantly to 18 (64% decrease) patients with 21 (70% decrease) echo abnormalities. Wall motion abnormalities resolved in 27 (90% decrease) patients (P < 0.01), left ventricular hypertrophy resolved in 14 (70% decrease) patients (P < 0.01), and mitral regurgitation resolved in 12 (75% decrease) patients (P < 0.01). Aortic regurgitation and left ventricle dilation resolved in 2 patients. However, right ventricle dilation significantly increased in 8 patients (P < 0.01). Mean ejection fraction at discharge was 56.9% (range 45%-89%). Overall survival was 96% at a mean follow-up of 4 y (range 2-6 y).
Conclusion:
Majority of echocardiographic abnormalities in donor hearts resolve prior to discharge and 4 y survival rates are excellent.
