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Updated: May 5, 2026
Pre-clinical Model of Cardiac Donation after Circulatory Death
Published on: August 2, 2019
A comparative analysis of echocardiographic data for heart transplant eligibility in brain death cases
Azadeh Sadatnaseri1, Marzieh Latifi2,3, Habib Rahban4,5
1Department of Cardiology, Tehran University of Medical Sciences, Sina University Hospital, Tehran, Iran, Islamic Republic of.
Insights
The cause of brain death significantly impacts heart transplant eligibility, influencing left ventricular ejection fraction. Reevaluating borderline cases can expand the donor pool for critical heart transplants.
Area of Science:
- Cardiology
- Transplant Surgery
- Medical Imaging
Background:
- The demand for donor hearts significantly exceeds supply, leading to critical shortages.
- This disparity results in prolonged waiting times and increased mortality for patients awaiting heart transplants.
- Echocardiographic assessment is crucial for evaluating potential heart donors.
Purpose of the Study:
- To compare echocardiographic data between hearts eligible and ineligible for transplant.
- To identify factors influencing heart transplant eligibility based on echocardiographic findings.
Main Methods:
- Retrospective, cross-sectional study of brain-death cases at Sina Hospital, Tehran.
- Evaluation of 59 eligible and 39 non-eligible hearts using transthoracic echocardiography data.
- Statistical analysis using SPSS 18, with P < 0.05 considered significant.
Main Results:
- The average age of cases was 29.28 ± 10.59 years.
- Cause of brain death was significantly associated with transplant eligibility (P=0.04).
- Significant differences were observed in left ventricular ejection fraction (LVEF) based on the cause of brain death (P=0.029).
Conclusions:
- The cause of brain death is a key factor in heart transplant eligibility.
- Borderline cases warrant reevaluation with repeat echocardiograms or functional assessments.
- Optimizing donor pool assessment can help address the organ shortage crisis.
Background:
The supply of donor hearts has fallen short of the increasing demand. This widening gap has led to a crisis marked by long waiting times and high mortality rates among those on waiting lists. This study aimed to compare the echocardiographic data of individuals whose hearts were eligible for transplant.
Methods:
This retrospective, cross-sectional study investigated all eligible brain-death cases conducted at Sina Hospital in Tehran, Iran. Based on echocardiographic data, patients were evaluated for heart donation (59 hearts that were deemed eligible vs. 39 hearts that were non-eligible for donation). The study used a custom checklist based on transthoracic echocardiography data. Data were analyzed using SPSS 18 software. A P < 0.05 was considered statistically significant.
Result:
The average age of the cases was 29.28 ± 10.59 years. Gender was not significantly associated with transplant eligibility (P = 0.46). In contrast, the cause of brain death was a significant factor (P = 0.04). There were statistically significant differences between the cause of brain death and left ventricular ejection fraction (LVEF) (F = 3.14, η² = 0.094, P = 0.029). No significant relationship was found between the cause of brain death and regional wall motion abnormality (RWMA) or pulmonary artery systolic pressure (PASP).
Conclusion:
Borderline cases should undergo reevaluation using repeat transthoracic echocardiogram or echocardiographic assessments of heart function with inotropic medications to increase the pool of potential heart donors due to limited organ donor options.
