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Related Concept Videos

Cardiomyopathy II: Dilated Cardiomyopathy01:30

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Related Experiment Video

Updated: Jul 23, 2025

Large-Animal Model of Donation after Circulatory Death and Normothermic Regional Perfusion for Cardiac Assessment
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Left Ventricular Dysfunction Associated With Brain Death: Results From the Donor Heart Study.

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  • 1Division of Cardiovascular Medicine (K.K.K., H.L., B.W.).

Circulation
|July 19, 2023
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Summary

Left ventricular dysfunction occurs in 13% of brain-dead organ donors, sometimes reversing. This impacts heart transplant acceptance but not recipient survival.

Keywords:
brain deathheart transplantationlefttissue donorsventricular dysfunction

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Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Critical Care Medicine

Background:

  • Left ventricular dysfunction (LVD) in potential heart donors meeting brain death criteria often leads to donor heart nonuse.
  • The incidence and pathophysiology of LVD in this population remain poorly understood.
  • The Donor Heart Study (DHS) aimed to resolve these unknowns through a multisite prospective cohort study.

Purpose of the Study:

  • To determine the incidence and characteristics of left ventricular dysfunction in potential organ donors.
  • To assess the reversibility of LVD in brain-dead donors.
  • To evaluate the association between LVD, donor heart acceptance, and recipient outcomes.

Main Methods:

  • Enrolled 4333 potential donors by neurologic determination of death across 8 US organ procurement organizations.
  • Performed serial transthoracic echocardiograms (TTEs) to assess left ventricular ejection fraction (LVEF) and regional wall motion abnormalities.
  • Defined LVD as LVEF <50%, with reversibility if LVEF >50% on a subsequent TTE.

Main Results:

  • Initial TTEs in 3794 donors revealed LVD in 13% (493 donors).
  • LVD was associated with younger age, underweight status, and elevated NT-proBNP and troponin levels.
  • Of 224 donors with initial LVD, 58% showed reversible dysfunction; 60% of hearts with normal function were accepted vs. 56% with reversible LVD and 24% with nonreversible LVD.

Conclusions:

  • Left ventricular dysfunction is common in brain-dead donors and can be reversible.
  • Findings can inform donor evaluation and heart acceptance decisions.
  • Donor LVD, reversible or not, did not impact 1-year recipient survival.