Use of Cardiac Allografts With Mild and Moderate Left Ventricular Hypertrophy Can Be Safely Used in Heart Transplantation to Expand the Donor Pool

Goland, Sorel; Czer, L.; Kass, Robert M.; Siegel, Robert J.; Mirocha, James; Robertis, Michele A. De; Lee, Jason; Raissi, Sharo; Cheng, Wen; Fontana, Gregory P.; Trento, Alfredo

doi:10.1016/j.jacc.2007.11.052

Cited by 44 publications

(41 citation statements)

References 20 publications

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“…Among 427 cases, 62 had interventricular septum thickness >12 mm. Survival in patients with or without left ventricular septum thickness >12 mm was similar [3]. The presence of donor coronary artery lesions has always been considered exclusion criteria.…”

Section: Discussionmentioning

confidence: 89%

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Impact of donor quality on outcome of heart transplantation☆☆☆

Forni

Luciani

Chiominto

et al. 2010

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 89%

“…Mild-to-moderate left ventricular hypertrophy may also not be considered an exclusion criteria any more. Since short-and long-term postoperative evaluations were similar in the two different recipient groups with organs from elderly donors, Goland et al indicated that mild-to-moderate left ventricular hypertrophy could be tolerated [3].…”

Section: Introductionmentioning

confidence: 99%

Impact of donor quality on outcome of heart transplantation☆☆☆

Forni

Luciani

Chiominto

et al. 2010

European Journal of Cardio-Thoracic Surgery

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“…6,7,12,13 Baseline donor CAD and left ventricular hypertrophy appear to increase the risk of significant CAV (especially early after OHT). 5,14,15 Recipient risk factors for CAV include higher recipient body mass index, older age, male recipient, prior ischemic heart disease, ventricular assist device support, and recent infection. 6,7,12 Traditional atherosclerotic risk factors such as hypertension, hyperlipidemia (including triglyceride/highdensity lipoprotein ratio .3), diabetes, and smoking also increase the risk of CAV.…”

Section: Risk Factorsmentioning

confidence: 99%

Transplant coronary heart disease: challenges and solutions

Jentzer¹,

Hickey²,

Khandhar³

2014

TRRM

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Cardiac allograft vasculopathy (CAV) remains one of the leading causes of death and graft failure after heart transplantation. A variety of causes, including donor heart characteristics, recipient risk factors, and immune-mediated influences, are associated with developing CAV. In this review, we will focus on the pathophysiology of developing CAV and various methods to screen for this condition. The pathogenesis of CAV likely involves repeated injuries to the endothelium from a variety of factors such as cellular-mediated rejection, and alloimmune factors, including antibody-mediated injury, ischemia-reperfusion injury at time of transplant, cytomegalovirus infections, immunosuppression medications, systemic inflammation, and traditional atherosclerosis risk factors. Patients with significant CAV are often asymptomatic, and therefore early detection by routine screening prior to graft dysfunction is crucial. There are a variety of invasive, noninvasive, and blood tests that have been studied as screening methods, and we will discuss the role of each of these in this review article. Although some treatment regimens have been established for CAV, this is an area where further studies and research are necessary.

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“…The presence of LV hypertrophy may also deter the use of donor hearts (73). However, recent studies demonstrated that hearts with mild to moderate left ventricular hypertrophy have similar short-and longer-term outcomes provided other risk factors are simultaneously considered (e.g., ischemic time) (74). There are few data comparing echocardiographic findings and pulmonary artery catheter measurements, but recent reports suggest that many hearts with adverse initial hemodynamics or echocardiography can be successfully managed to a state where transplantation is possible (8).…”

Section: Echocardiographic Assessment Of the Donor Heartmentioning

confidence: 99%

Assessment of the Potential Heart Donor

Dronavalli

Banner

Bonser

2010

Journal of the American College of Cardiology

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Demand for donor hearts exceeds supply, and a significant number of patients die while awaiting transplantation. Within the pool of currently unused potential donor hearts, a proportion may be suitable for transplantation but are declined due to anticipated poor function. Despite current assessment methods, in some donor hearts accepted for transplantation early graft failure develops in the recipient. Current methods of assessment are inadequate, and there is a potential for biomarkers to improve identification of satisfactory hearts for transplantation or hearts destined to fail in the recipient. Biomarkers are routinely used to diagnose and risk-stratify myocardial infarction, acute coronary syndromes, and heart failure. Some of these might facilitate donor heart assessment. Cardiac troponins, cytokines, inflammatory markers, natriuretic peptides, and intracellular proteins may each have discriminant value. This review details the current status of biomarkers in the assessment of donor hearts.

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Use of Cardiac Allografts With Mild and Moderate Left Ventricular Hypertrophy Can Be Safely Used in Heart Transplantation to Expand the Donor Pool

Abstract: Short- and long-term survival rates and rates of LVH at follow-up were similar in both groups, suggesting that donor hearts with mild and moderate LVH can be safely used in HTx.

Cited by 44 publications

References 20 publications

Impact of donor quality on outcome of heart transplantation☆☆☆

Impact of donor quality on outcome of heart transplantation☆☆☆

Transplant coronary heart disease: challenges and solutions

Assessment of the Potential Heart Donor

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