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Updated: Jun 19, 2026
Functional Assessment of the Donor Heart During Ex Situ Perfusion: Insights from Pressure-Volume Loops and Surface Echocardiography
Published on: October 11, 2022
Echocardiographic detection of dysfunctions in donor hearts
Rajamiyer Venkateswaran1, Robert Bonser, Richard Steeds
1Department of Cardiothoracic Surgery, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK. rajamiy@aol.com
Insights
Improving donor heart assessment with echocardiography can increase heart transplants. Advanced techniques enhance accuracy, reducing organ wastage and boosting transplant success rates.
Area of Science:
- Cardiology
- Transplantation Medicine
- Medical Imaging
Background:
- Declining heart transplantation rates worldwide necessitate improved donor organ utilization.
- Significant wastage of donor hearts occurs due to difficulties in accurate assessment.
- Current methods for evaluating donor hearts face limitations, impacting transplant viability.
Purpose of the Study:
- To explore the potential of echocardiography in improving donor heart assessment and selection.
- To address the challenges associated with echocardiographic evaluation in brainstem-dead donors.
- To investigate how technological advancements can enhance the accuracy of echocardiography for donor heart viability.
Main Methods:
- Utilizing echocardiography as a noninvasive tool for donor heart assessment.
- Addressing technical difficulties in acquiring optimal echocardiographic views.
- Incorporating advanced echocardiographic techniques such as left ventricular contrast, 3D imaging, and tissue Doppler studies.
Main Results:
- Echocardiography can guide donor heart optimization, potentially increasing the retrieval rate.
- Advanced echocardiographic techniques show promise in overcoming limitations of standard 2D imaging.
- Improved accuracy in donor heart assessment may lead to better utilization of available organs.
Conclusions:
- Echocardiography, particularly with advanced technologies, is crucial for accurate donor heart assessment.
- Overcoming technical challenges in echocardiography can significantly improve the selection of transplantable hearts.
- Enhanced echocardiographic assessment is vital to increase heart transplantation rates and reduce organ wastage.
Abstract:
Heart transplantation activity is steadily declining worldwide, despite initiatives to increase the donor pool. The yield of transplantable hearts remains low, leading to wastage of over two-thirds of donor organs. Accurate assessment and intervention is required to increase the number of transplantable hearts. The retrieval rate could be increased if techniques become available to differentiate between transplantable and nontransplantable hearts. Echocardiography is an ideally suited noninvasive investigation that may guide donor optimization. However, there are technical difficulties in acquiring high-quality views, and changes in ventricular function following catecholamine storm in brainstem death often lead to misinterpretation of standard 2D images. Current advances in technology, including the routine use of left ventricular contrast, 3D imaging and tissue doppler studies, may improve the accuracy, and thereby the utilization, of echocardiography in donor heart assessment.
