Heart Procurement from a Donor on Venovenous ECMO Support

Area of Science:

• Cardiology
• Transplantation Medicine
• Critical Care Medicine

Background:

• The demand for donor hearts significantly exceeds supply, leading to long waiting lists for heart transplantation.
• Extracorporeal membrane oxygenation (ECMO) is a life-support technology used in critical care for patients with severe cardiorespiratory failure.
• Donors on ECMO support are typically not considered for organ procurement due to concerns about organ viability and function.

Observation:

• A 37-year-old female donor with acute respiratory distress syndrome and anoxic brain injury was supported by venovenous extracorporeal membrane oxygenation (VV-ECMO).
• Preoperative evaluation deemed the donor heart suitable for transplantation.
• A 62-year-old female recipient with nonischemic cardiomyopathy and a HeartMate II mechanical assist device was identified as a potential candidate.

Findings:

• Orthotopic heart transplantation was successfully performed using the donor heart from an ECMO-supported patient.
• The recipient's postoperative course was not detailed, but the procedure itself was successful, indicating graft viability.
• This case demonstrates the feasibility of using hearts from carefully selected ECMO donors.

Implications:

• Procuring hearts from donors on ECMO support could potentially increase the availability of donor organs.
• Careful patient selection and thorough preoperative evaluation are crucial for successful outcomes when using organs from ECMO donors.
• This approach may offer a new avenue to expand the donor heart pool and reduce waiting times for heart transplantation.