title: The impact of cocaine on the donor heart: a case report.
abstract: With a limited supply of donor hearts in the United States and a prevalent history of cocaine abuse among potential heart donors, the question of transplanting the hearts of cocaine users presents a dilemma to the surgeon. We report a patient who died of the acute right ventricular failure of a heart from a donor with a history of binge drinking and cocaine abuse and who had sustained traumatic brain death. The donor's serum was positive for cocaine prior to transplantation, and autopsy findings were consistent with cocaine cardiomyopathy. This case illustrates the importance of accurate donor history and toxicologic screen prior to heart transplantation and suggests that hearts of cocaine users should not be transplanted, especially in a setting of traumatic brain death.
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Houser
authors.forename: T
authors.initials: T
authors.lastname: MacGillivray
authors.forename: H T
authors.initials: HT
authors.lastname: Aretz
mesh_terms: D000328:Adult; D000368:Aged; D019970:Cocaine-Related Disorders / Q000150:complications*; D016578:Crack Cocaine / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006321:Heart / Q000187:drug effects*; D006333:Heart Failure / Q000601:surgery; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D014019:Tissue Donors; D018497:Ventricular Dysfunction, Right / Q000139:chemically induced*
chemical_list: D016578:Crack Cocaine