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Updated: Aug 7, 2026
Heterotopic Heart Transplantation in Mice
Published on: July 19, 2007
Further cardiac transplant procedures in patients with heterotopic heart transplants
Insights
Second heart transplants offer survival benefits for select patients. While risks like infection and rejection exist, some patients experience long-term success with retransplantation, improving outcomes after initial heart transplants.
Area of Science:
- Cardiology
- Transplantation Surgery
Background:
- Heterotopic heart transplantation involves placing a donor heart alongside the recipient's native heart.
- Retransplantation may be necessary due to graft failure or complications.
Purpose of the Study:
- To evaluate outcomes of retransplantation in patients who previously received heterotopic heart transplants.
- To analyze the challenges and successes associated with a second heart transplant procedure.
Main Methods:
- Review of 7 patients who underwent a second heart transplant after an initial heterotopic procedure.
- Analysis of surgical approaches: excision of the first donor heart versus leaving it in situ.
- Assessment of patient survival, complications, and long-term graft function.
Main Results:
- Five patients had the initial donor heart excised and replaced; two had the initial donor heart kept in situ.
- Two patients died from infections within 3 months post-retransplantation.
- Four patients survived long-term (5-36 months post-second transplant), with one experiencing acute rejection but surviving 17 additional months.
Conclusions:
- Second heart transplantation can be a viable option for carefully selected patients.
- Challenges include managing infectious complications and graft arteriosclerosis.
- Long-term survival is achievable in a subset of patients undergoing retransplantation.
Abstract:
Seven patients with heterotopic heart transplants have undergone further heart transplant procedures. In 5, the first heterotopically placed donor heart was excised and replaced with the second donor heart. In 2, the first heterotopic donor heart was left in situ and the patient's own heart (then nonfunctioning) was excised and replaced by the second donor heart; thus, these patients underwent orthotopic transplantation and were left with two donor hearts. The decision to perform retransplantation in a patient undergoing irreversible acute rejection is usually straightforward, but the timing of a further transplant procedure in a patient with advanced graft arteriosclerosis may present a difficult problem. Two of the 7 patients in this series died of infectious complications within the first 3 months after retransplantation. A third patient acutely rejected the second donor heart within 5 days, but survived an additional 17 months with the support of his own cardiomyopathic heart. Four patients remain alive and well between 5 and 36 months following the second transplant and between 17 and 54 months following the first transplant procedure.
