Successful use of a cardiac allograft from tricyclic antidepressant intoxication

Marginal donor grafts in heart transplantation: lessons learned from 25 years of experience

“…The heart is usually hyperactive, with supraventricular tachycardia and a high cardiac output [115]. Evidence in the literature concerning suitability of donors poisoned with cyclic antidepressants is very poor; however, some authors report satisfying results in very selected cases emphasizing that the serum drug concentration in the donor has to be returned to normal and that the heart has to be without any noteworthy damage in an extensive hemodynamic assessment including serial Swan-Ganz catheter measurements [116].…”

Anti-depressive Therapies After Heart Transplantation

“…31 Ogawa et al reported the successful use of a cardiac allograft from TCA intoxication. 32 Because TCAs are hepatically metabolized, lower doses should be used in transplant recipients with hepatic impairment. 25 The secondary amines (i.e., nortriptyline), which require less hepatic metabolism, are preferable, 25 while nortriptyline's unique therapeutic window 33 allows toxicity monitoring.…”