Case ReportThoracic transplantationSuccessful Outcome Following Orthotopic Heart Transplantation With a Donor Half Way Across The Country
Section snippets
Case
A 68-year-old man with nonischemic cardiomyopathy was listed for heart transplant. He required multiple hospitalizations despite maximal medical therapy and placement of an implantable cardioverter defibrillator. A brain-dead donor with the same blood type became available, and our patient was selected as the first-priority recipient. The donor was a 57-year-old woman whose heart had an acceptable size match to the recipient (height, +11%; body weight, +50%) and normal biventricular function.
Discussion
Historically, Shumway et al initially obtained a donor heart from an operating room adjacent to the recipient operating room. Over time, the donor distance and ischemic time gradually increased. The advent of University of Wisconsin cold organ preservation solution decreased the amount of ischemic myocardial injury, thereby allowing even longer allograft ischemic time [4]. To date, the acceptable total allograft ischemic time for the transplanted human heart is reported to range up to 4 hours
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Cited by (8)
Successful heart transplants from over 2000 miles away
2024, Journal of Heart and Lung TransplantationExtended Static Hypothermic Preservation In Cardiac Transplantation: A Case Report
2021, Transplantation ProceedingsCold ischemia >4 hours increases heart transplantation mortality. An analysis of the Spanish heart transplantation registry
2020, International Journal of CardiologyCitation Excerpt :However, there still is uncertainty regarding the prognostic effect of CIT and of the cutoff value that might have relevant clinical implications. Some studies have reported no differences in survival even with prolonged CIT [13,14] or have described different cutoffs [15,16]. Our data suggest that we should be concern when ischemic time is longer than 4 h. Del Rizzo et al. also found a clear relation of CIT >4 h with mortality, but only in donors >50 years [17].
Relation of Length of Survival After Orthotopic Heart Transplantation to Age of the Donor
2020, American Journal of CardiologyCitation Excerpt :However, approximately 10% of all candidates on the waiting list for solid-organ transplantation die each year without receiving an organ.3 To surmount the organ shortage challenge, we have previously proposed alternative approaches to maximize organ allocation by utilizing marginally acceptable organs,5,6 harvesting donor hearts from distant locations,7 accepting longer cold ischemic times,8 utilizing obese donor hearts,9 and applying a domino heart transplantation as a uniquely efficacious surgical strategy.10 Although the mean donor age for heart transplant has increased from 31 years old in 1992 to 35 years old in 2013,11 only 3% of donor graft was from advanced-aged donor > 60 years.
The Stanford experience of heart transplantation over five decades
2021, European Heart Journal