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DOI: 10.1055/s-0030-1269070
Cardiac transplantation using hearts from donors with malignant CNS-tumors
Objectives: Donors with malignant tumors are usually excluded from the donor pool due to the risk of tumor development in the recipient. However, CNS-tumors rarely show development of metastases other than in the CNS and donors with malignant CNS-tumors might therefore be used more commonly in order to expand the donor pool.
Methods: We investigated the donors in our transplant program for the prevalence of malignant CNS-tumors and analysed the recipients of these organs in terms of cardiac function, survival and development of malignancies.
Results: From 01.01.2000 to 01.08.2010, we used seven donor organs from patients with CNS-malignancies. There were three astrocytomas, two glioblastomas and two anaplastic oligodendrogliomas. Donor age was from 30–51 years. All but one heart showed a good function after implantation. We observed one case of right heart failure in a patient with severe pulmonary hypertension. Implantation of a RVAD was performed and explanted after recovery of the right ventricle. The patient is alive and well. One patient deceased after 3 months due to multi-organ failure. Follow-up is from 1 month to over 8 years and we have not observed any kind of malignancy in these recipients.
Conclusions: Hearts from donors with CNS-malignancies can be used with good results in terms of hemodynamic performance and survival. Further studies are necessary to prove that transmission of malignant CNS-tumors is rare in heart transplant recipients.