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Successful cardiac transplantation from donor with carbon monoxide intoxication: a case report
1Department of Cardiovascular Surgery, Baskent University, Ankara, Turkey.
Insights
Successful heart transplants are possible using hearts from donors who died from carbon monoxide poisoning, provided cardiac function is adequate. This expands the donor pool for cardiac transplantation and reduces waiting list deaths.
Area of Science:
- Cardiology
- Transplantation Medicine
- Toxicology
Background:
- The viability of using hearts from donors with carbon monoxide (CO) intoxication for cardiac transplantation remains a debated topic.
- This report details a successful heart transplant from a brain-dead donor with a history of CO poisoning and cardiopulmonary resuscitation (CPR).
Observation:
- The donor heart exhibited preserved function, with a left ventricular ejection fraction of 55% and normal echocardiographic parameters, despite CPR.
- Donor liver biopsy showed no irreversible changes, and endomyocardial biopsy revealed no CO intoxication-related pathology post-transplant.
Findings:
- Successful cardiac transplantation was achieved using a standard biatrial technique with a donor ischemic time of 180 minutes.
- The recipient required short-term mechanical ventilation and early inotropic support, with no adverse events related to the donor's CO exposure.
Implications:
- Utilizing hearts from CO-intoxicated donors with adequate cardiac function can increase the availability of organs for transplantation.
- This approach may significantly reduce mortality rates for patients awaiting heart transplants.
Background:
The use of hearts for cardiac transplantation from donors with brain death due to exposure to high concentrations of carbon monoxide is still under discussion. In this short report we have presented a patient who underwent a successful cardiac transplantation from a brain-dead donor who had cardiopulmonary resuscitation after carbon monoxide intoxication.
Method:
A standard biatrial anastomosis technique was used in our patient. The transplantation was uneventful with donor ischemic time of 180 minutes. The patient was treated with mechanical ventilation for 72 hours. The donor liver biopsy during harvesting did not reveal irreversible changes. Although the donor had a history of cardiopulmonary resuscitation, the left ventricular ejection fraction was 55% and the echocardiographic evaluation revealed normal cardiac contractions with acceptable hemodynamic parameters. Positive inotropic support was needed in the early postoperative period. We did not observe any changes related to intoxication in the endomyocardial biopsy.
Conclusions:
We concluded that successful heart transplantation can be performed using hearts from patients succumbing to carbon monoxide poisoning in the presence of adequate cardiac functional parameters. This group will increase the number of cardiac transplantations and decrease the incidence of deaths among patients on transplantation lists.
