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Left ventricular dysfunction in potential heart donors and its influence on recipient outcomes
Jonatan Oras1, Rana Doueh1, Erik Norberg1
1Department of Anesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.
The Journal of Thoracic and Cardiovascular Surgery
|August 21, 2019
Summary
Left ventricular dysfunction is common in organ donors but does not harm recipients after heart transplantation. Utilizing these hearts could significantly increase heart transplant rates.
Area of Science:
- Cardiology
- Transplantation Medicine
- Organ Donation
Background:
- New-onset left ventricular (LV) dysfunction is frequent in organ donors and often leads to heart non-utilization.
- This dysfunction may be transient, potentially caused by sympathetic stress (Takotsubo syndrome).
Purpose of the Study:
- To assess the incidence, pattern, and predictors of LV dysfunction in potential heart donors.
- To evaluate the impact of donor LV dysfunction on recipient outcomes after heart transplantation.
Main Methods:
- Retrospective review of donor records in western Sweden (2006-2016).
- Echocardiographic assessment of potential heart donors.
- Recipient outcomes data from the Scandiatransplant database.
Main Results:
- LV dysfunction was identified in 24% of potential heart donors.
- Donor factors associated with LV dysfunction included younger age, cardiac arrest, inotropic support, and shorter time to brain death declaration.
- Hearts with LV dysfunction were transplanted in 14% of cases; recipient outcomes were similar to those receiving hearts without LV dysfunction, with LV function normalizing post-transplant.
Conclusions:
- Left ventricular dysfunction is prevalent in potential heart donors.
- Transplantation of donor hearts with LV dysfunction is safe and does not negatively impact recipient outcomes.
- Utilizing hearts with LV dysfunction could substantially increase heart transplantation rates.
Keywords:
Takotsubo syndromeheart donationheart failureheart transplantationleft ventricular dysfunctionMore Related Videos
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