Related Experiment Video
Updated: Nov 1, 2025
A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft
Published on: February 14, 2022
Prioritizing heart transplantation during the COVID-19 pandemic
Keki R Balsara1, Zakiur Rahaman1, Emily Sandhaus2
1Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Insights
This study found that a large heart transplant program increased its volume during the COVID-19 pandemic, with no change in patient survival. Aggressive testing prevented virus transmission among patients and staff.
Area of Science:
- Cardiology
- Transplant Surgery
- Infectious Disease Epidemiology
Background:
- The COVID-19 pandemic caused a nationwide decrease in surgical procedures.
- The pandemic's effect on organ donation and solid organ transplantation remains unclear.
- This study investigates the pandemic's impact on a high-volume heart transplant center.
Purpose of the Study:
- To assess the impact of the COVID-19 pandemic on heart transplant volume and outcomes.
- To evaluate changes in donor and recipient demographics, graft function, and survival rates.
- To determine the effectiveness of infection control measures in a transplant setting.
Main Methods:
- Retrospective review of adult heart transplants from March to June 2020, compared to 2019.
- Analysis of primary graft dysfunction, continuous renal replacement therapy (CRRT), and 30-day survival.
- Examination of donor and recipient demographics, including race.
Main Results:
- Heart transplant volume increased from 31 (2019) to 43 (2020).
- No significant differences in donor/recipient demographics or 30-day survival were observed.
- A significant increase in postoperative CRRT was noted (p=0.01), alongside a significant difference in patient race (p=0.029).
Conclusions:
- A large heart transplant program successfully increased its volume during the pandemic with stable clinical outcomes.
- Increased organ utilization may be attributed to reduced volume at other centers.
- An aggressive testing and surveillance program prevented COVID-19 transmission within the program.
Background:
Coronavirus disease 2019 (COVID-19) has significantly impacted the healthcare landscape in the United States in a variety of ways including a nation-wide reduction in operative volume. The impact of COVID-19 on the availability of donor organs and the impact on solid organ transplant remains unclear. We examine the impact of COVID-19 on a single, large-volume heart transplant program.
Methods:
A retrospective chart review was performed examining all adult heart transplants performed at a single institution between March 2020 and June 2020. This was compared to the same time frame in 2019. We examined incidence of primary graft dysfunction, continuous renal replacement therapy (CRRT) and 30-day survival.
Results:
From March to June 2020, 43 orthotopic heart transplants were performed compared to 31 performed during 2019. Donor and recipient demographics demonstrated no differences. There was no difference in 30-day survival. There was a statistically significant difference in incidence of postoperative CRRT (9/31 vs. 3/43; p = .01). There was a statistically significant difference in race (23 W/8B/1AA vs. 30 W/13B; p = .029).
Conclusion:
We demonstrate that a single, large-volume transplant program was able to grow volume with little difference in donor variables and clinical outcomes following transplant. While multiple reasons are possible, most likely the reduction of volume at other programs allowed us to utilize organs to which we would not have previously had access. More significantly, our growth in volume was coupled with no instances of COVID-19 infection or transmission amongst patients or staff due to an aggressive testing and surveillance program.
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