Survival is not compromised in donor hearts with echocardiographic abnormalities.
OBJECTIVE
To determine the effect of heart donors with echocardiographic abnormalities on short and long-term outcomes on heart transplant recipients.


METHODS
Retrospective chart review of heart donors used over 6 y. Donor charts provided demographic information, cause of death, and echo results. Recipient charts were queried for predischarge echo and survival results.


RESULTS
From January 1999 to December 2005, 485 heart transplants were performed. Of these, 50 donors had 70 echo abnormalities. Mean donor age was 32 y (range 4-51 y). Echo abnormalities included wall motion abnormality in 30 (60%), left ventricular hypertrophy in 20 (40%), mitral regurgitation in 16 (32%), aortic regurgitation in 2 (4%), and left ventricle dilation in 2 (4%). Mean ejection fraction was 54.0% (range 40%-70%). Echo abnormalities post-transplant decreased significantly to 18 (64% decrease) patients with 21 (70% decrease) echo abnormalities. Wall motion abnormalities resolved in 27 (90% decrease) patients (P < 0.01), left ventricular hypertrophy resolved in 14 (70% decrease) patients (P < 0.01), and mitral regurgitation resolved in 12 (75% decrease) patients (P < 0.01). Aortic regurgitation and left ventricle dilation resolved in 2 patients. However, right ventricle dilation significantly increased in 8 patients (P < 0.01). Mean ejection fraction at discharge was 56.9% (range 45%-89%). Overall survival was 96% at a mean follow-up of 4 y (range 2-6 y).


CONCLUSIONS
Majority of echocardiographic abnormalities in donor hearts resolve prior to discharge and 4 y survival rates are excellent.
Sopko
Nikolai
N
Case Western Reserve School of Medicine, Cleveland, Ohio, USA.
Shea
Kenneth J
KJ
Ludrosky
Kristen
K
Smedira
Nicholas
N
Hoercher
Katherine
K
Taylor
David O
DO
Starling
Randall C
RC
Gonzalez-Stawinski
Gonzalo V
GV
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D006085:Graft Survival / Q000502:physiology*; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D016027:Heart Transplantation / Q000401:mortality* / Q000473:pathology / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D014019:Tissue Donors