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Published on: June 6, 2025
Heart donation after a fatal stab wound to the right ventricle: a case report
Ricky Ng1, Maliha Khara2,3, Jayantha C Herath2,3
1Ontario Forensic Pathology Service, 25 Morton Shulman Avenue, North York, Toronto, M3M 0B1, ON, Canada. ricky.ng2@ontario.ca.
Insights
This case study shows a heart successfully donated after a fatal chest stab wound. Timely medical intervention enabled organ donation, even with traumatic heart injury.
Area of Science:
- Cardiology
- Transplantation Medicine
- Forensic Pathology
Background:
- Trauma victims are a crucial source of organ donors.
- Organ procurement is typically hindered by injuries to donor organs.
- Penetrating cardiac trauma often excludes victims from organ donation.
Purpose of the Study:
- To report the first case of heart donation following fatal penetrating cardiac trauma.
- To explore the potential for organ donation in trauma victims with severe injuries.
- To highlight the importance of medical and legal collaboration in facilitating organ donation.
Main Methods:
- Case presentation of a 37-year-old male with a stab wound to the right ventricle.
- Surgical repair of the cardiac injury.
- Organ procurement after declaration of brain death.
- Collaboration between medical teams and legal authorities.
Main Results:
- The heart was successfully repaired and subsequently donated.
- Organ donation did not compromise the forensic postmortem examination.
- This case demonstrates the feasibility of donating a traumatically injured heart.
Conclusions:
- Timely medical intervention and collaboration can enable organ donation even in cases of severe traumatic injury.
- This case challenges conventional criteria for organ procurement from trauma victims.
- There is an expanded potential for organ donation from traumatically injured organs, serving as a goal of medical intervention.
Abstract:
Trauma victims are a significant part of the donor pool, though injuries to donor organs normally exclude them from their procurement. We present the case of a 37-year-old male with a stab wound to the chest, resulting in penetrating sharp force injury to the right ventricle of the heart. Despite the ultimately fatal injury, the heart was successfully repaired, and later donated, after brain death. Resuscitation and surgical intervention, along with the collaboration of medical and legal parties, enabled heart donation to occur without compromising the quality of forensic postmortem examination. Though it is an extraordinary circumstance, it challenges norms regarding organ donation, and suggests an expanded potential for organ donation as a goal of timely medical intervention in addition to the survival of the patient, including for traumatically injured organs. This is the first reported case in which trauma to the heart, responsible for the death of the patient, preceded its donation.
