Can a "broken heart" successfully be transplanted? A brief report

Area of Science:

• Cardiology
• Transplantation Medicine
• Neurology

Background:

• Dilated ischemic cardiomyopathy necessitates urgent heart transplantation.
• Extracorporeal membrane oxygenation (ECMO) support was initiated for cardiogenic shock.
• A potential donor heart was identified after a ten-day waitlist period.

Observation:

• The donor, a 58-year-old woman, died from a ruptured cerebral aneurysm.
• The donor experienced left ventricle dysfunction secondary to Takotsubo syndrome.
• The explanted heart exhibited moderate dysfunction (ejection fraction of 40%) at the time of retrieval.

Findings:

• Takotsubo cardiomyopathy, or "broken heart syndrome," can result from surges in stress hormones following brain injury.
• Despite initial moderate dysfunction, the transplanted heart showed complete recovery of contractile function post-transplant.
• Outcomes for hearts with transient dysfunction at screening but normal function at retrieval are comparable to those without prior dysfunction.

Implications:

• This case suggests that hearts affected by Takotsubo cardiomyopathy may be viable for transplantation.
• Successful transplantation of a heart with transient dysfunction indicates potential for recovery.
• Further research into donor hearts with stress-induced cardiomyopathy is warranted to expand the donor pool.