Prevalence, determinants, and correlates of coagulation necrosis and contraction band necrosis in donor hearts

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Comprehensive Analysis of Procoagulant Platelets Exhibiting Features of Necrosis, Apoptosis and Platelet Activation
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Comprehensive Analysis of Procoagulant Platelets Exhibiting Features of Necrosis, Apoptosis and Platelet Activation

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Maya Guglin1, Hesham R Omar2, Gregory Ray3

  • 1Division of Cardiovascular Disease, University of Kentucky, Lexington, Kentucky.

Clinical Transplantation
|January 1, 2019
PubMed

Insights

Pathologic changes like coagulation necrosis (CN) and contraction band necrosis (CBN) are common in rejected donor hearts. CBN, linked to subarachnoid hemorrhage, may indicate a potentially reversible condition, offering hope for transplantation.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Pathology

Background:

  • Donor heart evaluation is crucial for transplantation success.
  • Identifying reversible cardiac conditions in rejected hearts can expand the donor pool.
  • Pathologic examination aids in understanding donor heart viability.

Purpose of the Study:

  • To explore pathologic changes in donor hearts.
  • To associate these findings with the mechanism of death.
  • To determine if specific pathologies correlate with potentially reversible conditions.

Main Methods:

  • Consecutive organ donors were enrolled over one year.
  • Hearts rejected for transplantation underwent pathological examination.
  • Association between pathologic findings and donor's cause of death was analyzed.

Main Results:

  • 81 hearts were examined; coagulation necrosis (CN) found in 17.3%, contraction band necrosis (CBN) in 34.6%.
  • CN associated with anoxic brain injury (P=0.002).
  • CBN linked to subarachnoid hemorrhage (P=0.017) and lower LVEF (P=0.017).

Conclusions:

  • CN and CBN are prevalent in rejected donor hearts.
  • CBN is associated with subarachnoid hemorrhage and may indicate catecholamine-induced cardiomyopathy.
  • This reversibility potential of CBN could impact donor heart utilization.
Abstract

Keywords:
coagulation necrosiscontraction band necrosisheart transplantationneurogenic stunned myocardiumstress-induced cardiomyopathy

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