Size matching in heart transplantation.
After heart transplantation, problems may arise from hearts that are either too small or too large. Although the "classic" rule requires that the donor/recipient weight ratio mismatch measure not less than 0.8, the chronic organ shortage led to a challenge of that margin. In selected cases donor/recipient weight mismatches of up to 0.5 may be accepted. In these circumstances, heterotopic heart transplantation may be an alternative. In pediatric heart transplantation, disproportionately large hearts (donor/recipient weight mismatches of 2.0 to 3.0) may create the so-called "big-heart syndrome," with coma and general convulsions. Treatment consists of peripheral pressure control with nifedipine.
Reichart
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Department of Cardiac Surgery, Ludwig-Maximilians-University of Munich, Germany.
D000328:Adult; D001824:Body Constitution; D002648:Child; D005260:Female; D006321:Heart / Q000033:anatomy & histology*; D016027:Heart Transplantation / Q000592:standards; D006801:Humans; D008297:Male; D009929:Organ Size; D011183:Postoperative Complications / Q000209:etiology; D014019:Tissue Donors; D016042:Transplantation, Heterotopic